reglab/housing_qa huggingface dataset:
24-A ME Rev Stat § 2828 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2828. Time for suits

 §2828. Time for suits There shall be a provision that no action at law or in equity shall be brought to recover on the policy prior to the expiration of 60 days after proof of loss has been filed in accordance with the requirements of the policy and that no such action shall be brought at all, unless brought within 2 years from the expiration of the time within which proof of loss is required by the policy.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2829 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2829. Exceptions

 §2829. Exceptions 1.  Any portion of any such policy, delivered or issued for delivery in this State, which purports, by reason of the circumstances under which a loss is incurred, to reduce any benefits promised thereunder to an amount less than that provided for the same loss occurring under ordinary circumstances, shall be printed in such policy and in each certificate issued thereunder, in bold face type and with greater prominence than any other portion of the rest of such policy or certificate, respectively; and all other exceptions of the policy shall be printed in the policy and certificate with the same prominence as the benefits to which they apply.   [PL 1969, c. 132, §1 (NEW).] 2.  If any such policy contains any provision which affects the liability of the insurer because of any violation of law by the insured during the term of the policy, it shall be in the following form: The insurer shall not be liable for death, injury incurred or disease contracted, to which a contributing cause was the insured's commission of or attempt to commit a felony, or which occurs while the insured is engaged in an illegal occupation.   [PL 1969, c. 132, §1 (NEW).] 3.  If any such policy contains any provision which affects the liability of the insurer because of the insured's use of intoxicating liquor or narcotics or hallucinogenic drugs during the term of the policy, it shall be in the following form: The insurer shall not be liable for death, injury incurred or disease contracted while the insured is intoxicated or under the influence of narcotics or hallucinogenic drugs unless administered on the advice of a physician.   [PL 1969, c. 132, §1 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2829-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2829-A. Disability benefit offsets

 §2829-A. Disability benefit offsets 1.  Disclosure to persons eligible for coverage.  For any policy or contract subject to this chapter that provides disability income benefits, if the benefits under that policy or contract are subject to reduction due to other sources of income, then the insurer shall include in any written enrollment material and certificate of coverage developed by the insurer that is intended to be distributed to persons eligible for coverage under the policy or contract a clear and conspicuous notice that accurately explains all types of other sources of income that may result in a reduction of the benefits payable under the policy or contract. The notice requirement under this section does not apply to an advertisement intended for the general public.   [PL 2005, c. 42, §2 (NEW).] 2.  Recovery of disability benefit overpayments.  For claims filed after January 1, 2006, an insurer that is entitled to reduce disability income benefit payments when the insured receives income from other sources and that is entitled to recover overpayments through offsets against current payments to the insured may not recover such overpayments at a rate greater than 20% of the net benefit per benefit payment period unless:   A. For policies applied for after September 13, 2003, the insurer has complied with the requirements of subsection 1;   [PL 2005, c. 42, §2 (NEW).]B. The insurer effects the offset of benefits within 60 days of notice to the insurer, or such later date as the insurer begins paying benefits to the insured, that the insured is receiving or is entitled to receive income that may result in a reduction of benefits payable under the policy;   [PL 2005, c. 42, §2 (NEW).]C. The overpayment did not result from the insurer's miscalculation of benefit reductions or the insurer's miscalculation of benefits payable under the policy; and   [PL 2005, c. 42, §2 (NEW).]D. The insurer provided the insured with clear and conspicuous written notice that accurately explains to the insured all types of other sources of income that may result in a reduction of the benefits payable under the policy within 30 days of the date a claim for disability benefits was filed.   [PL 2005, c. 42, §2 (NEW).][PL 2005, c. 42, §2 (NEW).] SECTION HISTORY PL 2003, c. 321, §2 (NEW). PL 2005, c. 42, §2 (RPR).
24-A ME Rev Stat § 2830 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2830. Omissions, modifications: superintendent may approve

 §2830. Omissions, modifications: superintendent may approve The superintendent may approve any form of group or blanket health insurance policy, or any form of certificate or printed information to be issued under such policy, that omits or modifies any of the provisions hereinbefore required, if the superintendent considers such omission or modification suitable for the character of such insurance and not unjust to the persons insured thereunder.   [RR 2021, c. 1, Pt. B, §246 (COR).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD). RR 2021, c. 1, Pt. B, §246 (COR).
24-A ME Rev Stat § 2831 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2831. Hospital, medical benefits; direct payment

 §2831. Hospital, medical benefits; direct payment Any such group or blanket policy may include benefits payable on account of hospital or medical or surgical aid for an employee or other member of the group insured by such policy, the employee's or other member's spouse, child or children or other dependents, and may provide that, at the insured's option, any such benefits be paid by the insurer directly to the hospital, physician, surgeon doctor, nurse or other person furnishing services covered by such provisions of the policy.   [RR 2021, c. 1, Pt. B, §247 (COR).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1987, c. 219 (AMD). RR 2021, c. 1, Pt. B, §247 (COR).
24-A ME Rev Stat § 2832 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2832. Maternity benefits for unmarried women certificate holders and the minor dependents of certificate holders with dependent or family coverage required

 §2832. Maternity benefits for unmarried women certificate holders and the minor dependents of certificate holders with dependent or family coverage required All group or blanket health insurance policies, contracts and certificates shall provide the same maternity benefits for unmarried women certificate holders, and the minor dependents of certificate holders with dependent or family coverage, as is provided married certificate holders with maternity coverage and the wives of certificate holders with maternity coverage. This requirement applies to all group or blanket insurance written or renewed after the effective date of this Act, and includes, but is not limited to, all types and forms of group insurance issued by individual companies or corporations.   [PL 2003, c. 517, Pt. B, §11 (AMD).]SECTION HISTORY PL 1975, c. 276, §3 (NEW). PL 1975, c. 428, §3 (NEW). PL 1975, c. 471, §2 (NEW). PL 1975, c. 562 (NEW). PL 1975, c. 770, §§105-107 (RP). PL 1979, c. 663, §146 (AMD). PL 2003, c. 517, §B11 (AMD).
24-A ME Rev Stat § 2833 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2833. Child coverage

 §2833. Child coverage 1.  Definitions.  For the purposes of this section, unless the context otherwise indicates, the following terms have the following meanings.   A. "Dependent children" means children who are under 19 years of age and are children, stepchildren or adopted children of, or children placed for adoption with, the certificate holder, member or spouse of the certificate holder or member.   [PL 1993, c. 666, Pt. A, §5 (NEW).]B. "Placed for adoption" means the assumption and retention of a legal obligation by a person for the total or partial support of a child in anticipation of adoption of the child. If the legal obligation ceases to exist, the child is no longer considered placed for adoption.   [PL 1993, c. 666, Pt. A, §5 (NEW).][PL 1993, c. 666, Pt. A, §5 (RPR).] 2.  Coverage.  All group or blanket health insurance plans issued in accordance with the requirements of section 2832 must provide unmarried women certificate holders with the option of coverage of their children from the date of birth. A certificate holder who, pursuant to the laws of this State or any other state, has been adjudicated or has acknowledged the certificate holder to be the father of an illegitimate child must be given the option of coverage for that child from the date of the certificate holder's adjudication or acknowledgement of paternity. This optional coverage must be the same as that provided the children of a married certificate holder with family or dependent coverage.   [RR 2021, c. 1, Pt. B, §248 (COR).] 3.  Financial dependency.  Financial dependency of dependent children on the certificate holder or the spouse of the certificate holder may not be required as a condition for eligibility for coverage.   [PL 1991, c. 200, Pt. B, §4 (NEW).] 4.  Adopted children.  All group or blanket health insurance policies and certificates issued in accordance with the requirements of this section must provide the same benefits to dependent children placed for adoption with the certificate holder or spouse of the certificate holder under the same terms and conditions as apply to natural dependent children or stepchildren of the certificate holder, irrespective of whether the adoption has become final.   [PL 1993, c. 666, Pt. A, §6 (NEW).] SECTION HISTORY PL 1975, c. 276, §3 (NEW). PL 1979, c. 663, §147 (AMD). PL 1985, c. 652, §52 (AMD). PL 1991, c. 200, §B4 (RPR). PL 1993, c. 666, §§A5,6 (AMD). RR 2021, c. 1, Pt. B, §248 (COR).
24-A ME Rev Stat § 2833-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2833-A. Extension of coverage for dependent children

 §2833-A. Extension of coverage for dependent children Notwithstanding section 2822, a group health insurance policy that provides coverage for a dependent child at certain ages only if the child is a student must continue that coverage if the child is unable to remain enrolled in school on a full-time basis due to a mental or physical illness or an accidental injury. This coverage may be terminated at the age at which coverage for students terminates under the terms of the policy. An insurer may require, as a condition of eligibility for continued coverage in accordance with this section, that the student provide written documentation from a health care provider and the student's school that the student is no longer enrolled in school on a full-time basis due to a mental or physical illness or accidental injury.   [PL 2005, c. 532, §2 (NEW).]SECTION HISTORY PL 2005, c. 532, §2 (NEW).
24-A ME Rev Stat § 2833-B (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2833-B. Mandatory offer to extend coverage for dependent children up to 26 years of age

 §2833-B. Mandatory offer to extend coverage for dependent children up to 26 years of age 1.  Dependent child; definition.  As used in this section, "dependent child" means the child of a person covered under a group health insurance policy.   A. [PL 2019, c. 5, Pt. A, §13 (RP).] B. [PL 2019, c. 5, Pt. A, §13 (RP).] C. [PL 2019, c. 5, Pt. A, §13 (RP).] D. [PL 2007, c. 514, §8 (RP).] [PL 2019, c. 5, Pt. A, §13 (AMD).] 2.  Offer of coverage.  Notwithstanding section 2822, a group health insurance policy that offers coverage for a dependent child must offer such coverage, at the option of the parent, until the dependent child attains 26 years of age.   [PL 2019, c. 5, Pt. A, §13 (AMD).] 3.  Notice.   [PL 2007, c. 514, §10 (NEW); MRSA T. 24-A §2833-B, sub-§3 (RP).] SECTION HISTORY PL 2007, c. 115, §2 (NEW). PL 2007, c. 115, §5 (AFF). PL 2007, c. 514, §§6-10 (AMD). PL 2019, c. 5, Pt. A, §13 (AMD).
24-A ME Rev Stat § 2834 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2834. Newborn children coverage

 §2834. Newborn children coverage All group and blanket health insurance policies and certificates providing coverage on an expense-incurred basis must provide that health insurance benefits are payable for a newly born child of the insured or subscriber from the moment of birth. An adopted child is deemed to be newly born to the adoptive parents from the date of the signed placement agreement. Preexisting conditions of an adopted child may not be excluded from coverage.   [PL 2003, c. 517, Pt. A, §5 (AMD); PL 2003, c. 517, Pt. A, §13 (AFF).]The coverage for newly born children must consist of coverage of injury or sickness or other benefits provided by the policy, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities.   [PL 1997, c. 604, Pt. C, §3 (AMD).]If payment of a specific premium or subscription fee is required to provide coverage for a child, the policy or contract may require that notification of birth of a newly born child and payment of the required premium or fees must be furnished to the insurer or nonprofit service or indemnity corporation within 31 days after the date of birth in order to have the coverage continue beyond that 31-day period. The payment may be required to be retroactive to the date of birth. Benefits required by section 2834‑A must be paid regardless of whether coverage under this section is elected.   [PL 1997, c. 604, Pt. C, §3 (AMD).]The requirements of this section apply to all policies and certificates delivered or issued for delivery in this State.   [PL 2003, c. 517, Pt. A, §6 (AMD); PL 2003, c. 517, Pt. A, §13 (AFF).]SECTION HISTORY PL 1975, c. 770, §108 (NEW). PL 1993, c. 686, §12 (AMD). PL 1993, c. 686, §13 (AFF). PL 1995, c. 332, §N3 (AMD). PL 1997, c. 604, §C3 (AMD). PL 2003, c. 517, §§A5,6 (AMD). PL 2003, c. 517, §A13 (AFF).
24-A ME Rev Stat § 2834-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2834-A. Maternity and routine newborn care

 §2834-A. Maternity and routine newborn care An insurer that issues group contracts and certificates providing maternity benefits, including benefits for childbirth, shall provide coverage for services related to maternity and routine newborn care, including coverage for hospital stay, in accordance with the attending physician's or attending certified nurse midwife's determination in conjunction with the mother that the mother and newborn meet the criteria outlined in the "Guidelines for Perinatal Care," published by the American Academy of Pediatrics and the American College of Obstetrics and Gynecology. For the purposes of this section, "routine newborn care" does not include any services provided after the mother has been discharged from the hospital. For the purposes of this section, "attending physician" includes the obstetrician, pediatrician or other physician attending the mother and newborn. Benefits for routine newborn care required by this section are part of the mother's benefit. The mother and the newborn are treated as one person in calculating the deductible, coinsurance and copayments for coverage required by this section.   [PL 2003, c. 517, Pt. B, §12 (AMD).]SECTION HISTORY PL 1995, c. 615, §3 (NEW). PL 2001, c. 258, §A3 (AMD). PL 2003, c. 517, §B12 (AMD).
24-A ME Rev Stat § 2834-C (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2834-C. Compliance with federal law

 §2834-C. Compliance with federal law 1.  Application.  This section applies to all group and blanket medical insurance policies issued by nonprofit hospital or medical service organizations, insurers or health maintenance organizations except hospital indemnity, accidental injury, specified disease and long-term care policies.   [PL 2009, c. 244, Pt. E, §1 (NEW).] 2.  Requirement.  Policies subject to this section must comply with the federal Children's Health Insurance Program Reauthorization Act of 2009, Section 311 concerning special enrollment periods in case of termination of coverage under a Medicaid plan or a state child health plan or eligibility for assistance in the purchase of employment-based coverage.   [PL 2009, c. 244, Pt. E, §1 (NEW).] SECTION HISTORY PL 2009, c. 244, Pt. E, §1 (NEW).
24-A ME Rev Stat § 2836 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2836. Limits on priority liens

 §2836. Limits on priority liens No group or blanket policy shall provide for priority over the insured member of payment for any hospital, nursing, medical or surgical services, or of any expenses paid or reimbursed under the policy, in the event the insured member is entitled to receive payment reimbursement from any other person as a result of legal action or claim, except as provided in this section.   [PL 1975, c. 770, §108 (NEW).]A policy may contain a provision that allows such payments, if that provision is approved by the superintendent, and if that provision requires the prior written approval of the insured member and allows such payments only on a just and equitable basis, and not on the basis of a priority lien. A just and equitable basis shall mean that any factors that diminish the potential value of the insured member's claim shall likewise reduce the share in the claim for those claiming payment for services or reimbursement. Such factors shall include, but are not limited to:   [PL 1975, c. 770, §108 (NEW).]1.  Legal defenses.  Questions of liability and comparative negligence or other legal defenses;   [PL 1975, c. 770, §108 (NEW).] 2.  Exigencies of trial.  Exigencies of trial that reduce a settlement or award in order to resolve the claim; and   [PL 1975, c. 770, §108 (NEW).] 3.  Limits of coverage.  Limits on the amount of applicable insurance coverage that reduce the claim to an amount recoverable by the insured member.   [PL 1975, c. 770, §108 (NEW).] In the event of a dispute as to the application of any such provision or the amount available for payment to those claiming payment for services or reimbursement, the dispute shall be determined if the action is pending, before the court in which it is pending; or if no action is pending, by filing an action in any court for determination of the dispute.   [PL 1975, c. 770, §108 (NEW).]SECTION HISTORY PL 1975, c. 770, §108 (NEW).
24-A ME Rev Stat § 2837-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2837-A. Screening mammograms

 §2837-A. Screening mammograms 1.  Definition.  For purposes of this section, "screening mammogram" means a radiologic procedure that is provided to an asymptomatic woman for the purpose of early detection of breast cancer and that consists of 2 radiographic views per breast. A screening mammogram also includes an additional radiologic procedure recommended by a provider when the results of an initial radiologic procedure are not definitive.   [PL 2007, c. 153, §2 (AMD); PL 2007, c. 153, §5 (AFF).] 2.  Required coverage.  All group insurance policies that cover radiologic procedures, except those policies that cover only dental procedures, accidental injury or specific diseases, must provide coverage for screening mammograms performed by providers that meet the standards established by the Department of Health and Human Services rules relating to radiation protection. The policies must reimburse for screening mammograms performed at least once a year for women 40 years of age and over.   A.   [PL 1997, c. 408, §5 (RP); PL 1997, c. 408, §8 (AFF).]B.   [PL 1997, c. 408, §5 (RP); PL 1997, c. 408, §8 (AFF).][PL 1997, c. 408, §5 (RPR); PL 1997, c. 408, §8 (AFF); PL 2003, c. 689, Pt. B, §6 (REV).] 3.  Application.  This section applies to all policies, contracts and certificates that cover radiologic procedures, except those policies that cover only dental procedures, accidental injury or specific diseases, executed, delivered, issued for delivery, continued or renewed in this State on or after March 1, 1991. For purposes of this section, all policies and contracts are deemed to be renewed no later than the next yearly anniversary of the policy or contract date.   [PL 1991, c. 156, §2 (AMD).] 4.  Reports.  Each insurer that issues policies subject to this section shall report to the superintendent its experience for each calendar year beginning with 1991 not later than April 30th of the following calendar year. The report must include the information required and be presented in the form prescribed by the superintendent. The report must include the amount of claims paid in this State for services required by this section. The superintendent shall compile this data in an annual report and submit the report to the joint standing committee of the Legislature having jurisdiction over banking and insurance matters.   [PL 1991, c. 701, §9 (AMD).] SECTION HISTORY PL 1989, c. 875, §I6 (NEW). PL 1991, c. 156, §2 (AMD). PL 1991, c. 701, §9 (AMD). PL 1997, c. 408, §5 (AMD). PL 1997, c. 408, §8 (AFF). PL 2003, c. 689, §B6 (REV). PL 2007, c. 153, §2 (AMD). PL 2007, c. 153, §5 (AFF).
24-A ME Rev Stat § 2837-B (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2837-B. Acupuncture services

 §2837-B. Acupuncture services All group insurance policies and certificates providing coverage for acupuncture must provide coverage for those services when performed by an acupuncturist licensed pursuant to Title 32, chapter 113‑B, subchapter 2, under the same conditions that apply to the services of a licensed physician.   [PL 2003, c. 517, Pt. B, §14 (AMD).]SECTION HISTORY PL 1991, c. 647, §3 (NEW). PL 1995, c. 671, §10 (AMD). PL 2003, c. 517, §B14 (AMD).