reglab/housing_qa huggingface dataset:
24-A ME Rev Stat § 2807-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2807-A. Credit union groups

 §2807-A. Credit union groups A group of individuals may be insured under a policy issued to a credit union or to a trustee or trustees or agent designated by 2 or more credit unions, which credit union, trustee, trustees or agent is considered the policyholder, to insure members of the credit union or credit unions for the benefit of persons other than the credit union or credit unions, trustee or trustees or agent or any of their officials, subject to the following requirements.   [PL 1981, c. 147, §7 (NEW).]1.  The members eligible for insurance are all of the members of the credit union or credit unions or all of any class or classes thereof.   [PL 1981, c. 147, §7 (NEW).] 2.  The premium for the policy shall be paid either from funds of the credit union or from funds contributed by the insured members specifically for their insurance, or from both. Except as provided in subsection 3, a policy on which no part of the premium is to be derived from funds contributed by the insured members specifically for their insurance must insure all eligible members, except those who reject the coverage in writing.   [PL 1981, c. 147, §7 (NEW).] 3.  Except as provided in section 2736‑C, section 2808‑B and chapter 36, an insurer may exclude or limit the coverage on any member as to whom evidence of individual insurability is not satisfactory to the insurer.   [PL 1999, c. 256, Pt. G, §5 (AMD).] SECTION HISTORY PL 1981, c. 147, §7 (NEW). PL 1989, c. 867, §§6,10 (AMD). PL 1999, c. 256, §G5 (AMD).
24-A ME Rev Stat § 2808 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2808. Other groups

 §2808. Other groups Group health insurance offered to a resident of this State under a group health insurance policy issued to a group other than one described in sections 2804 to 2807-A is subject to the following requirements.   [PL 1981, c. 147, §8 (RPR).]1.  No group health insurance policy may be delivered in this State, pursuant to this section, unless the superintendent finds that:   A. The policyholder is a bona fide group formed for purposes other than procurement of insurance;   [PL 1987, c. 476, §4 (AMD).]B. The issuance of the group policy would be actuarially sound;   [PL 1981, c. 147, §8 (NEW).]C. The issuance of the group policy would result in economies of acquisition or administration; and   [PL 1987, c. 476, §4 (AMD).]D. The benefits are reasonable in relation to the premiums charged.   [PL 1981, c. 147, §8 (NEW).][PL 1987, c. 476, §4 (AMD).] 2.  No group health insurance coverage may be offered in this State, pursuant to this section, by an insurer under a policy issued in another state, unless the superintendent has made a determination that the requirements of subsection 1, paragraphs A, B, C and D have been met.   [PL 1987, c. 476, §5 (RPR).] 2-A.  Notwithstanding subsections 1 and 2, an employee leasing company registered pursuant to Title 32, chapter 125 qualifies as an eligible group for purposes of the purchase of group health insurance as provided in this section.   [PL 1997, c. 393, Pt. A, §26 (AMD).] 3.  The premium for the policy shall be paid either from the policyholder's funds or from funds contributed by the covered persons, or from both.   [PL 1981, c. 147, §8 (NEW).] 4.  Except as provided in section 2736‑C, section 2808‑B and chapter 36, an insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer.   [PL 1999, c. 256, Pt. G, §6 (AMD).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD). PL 1981, c. 147, §8 (RPR). PL 1987, c. 476, §§4,5 (AMD). PL 1989, c. 867, §§7,10 (AMD). PL 1995, c. 618, §3 (AMD). PL 1997, c. 393, §A26 (AMD). PL 1999, c. 256, §G6 (AMD).
24-A ME Rev Stat § 2808-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2808-A. Rating practices in group health insurance (REPEALED)

 §2808-A. Rating practices in group health insurance (REPEALED)SECTION HISTORY PL 1989, c. 422, §2 (NEW). PL 1991, c. 353 (AMD). PL 1991, c. 696 (AMD). PL 1991, c. 828, §24 (AMD). PL 1995, c. 332, §B1 (RP).
24-A ME Rev Stat § 2809 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2809. Coverage of family, dependents; continuation of coverage

 §2809. Coverage of family, dependents; continuation of coverage 1.  Any policy of group health insurance issued pursuant to sections 2804 (employee groups), 2805 (labor union groups), 2805-A (association groups), 2806 (trustee groups), 2807-A (credit union groups) or 2808 (other groups) may include coverage for members of the family or dependents of individuals otherwise insured in such groups.   [PL 1981, c. 147, §9 (AMD).] 1-A.  Any such policy of group health insurance that provides coverage for family members or dependents of individuals in the insured group may not define the terms "family" or "dependent" to exclude from coverage those minor children of any covered individual who do not reside with that individual. Insurers must comply with 42 United States Code, Section 1396g‑1.   [PL 1995, c. 418, Pt. C, §3 (AMD).] 2.  Any group health insurance policy which contains provisions for the payment by the insurer of benefits for expenses incurred on account of hospital, nursing, medical or surgical services for members of the family or dependents of an individual in the insured group may provide for the continuation of such benefit provisions, or any part or parts thereof, after the death of such individual.   [PL 1969, c. 132, §1 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1981, c. 147, §9 (AMD). PL 1985, c. 652, §51 (AMD). PL 1995, c. 418, §C3 (AMD).
24-A ME Rev Stat § 2810 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2810. Group health insurance payments; beneficiaries

 §2810. Group health insurance payments; beneficiaries The benefits payable under any policy or contract of group health insurance shall be payable to the employee or other insured member of the group or to some beneficiary or beneficiaries designated by him, other than the employer or the association or any officer thereof as such; but if there is no designated beneficiary as to all or any part of the insurance at the death of the employee or member, then the amount of insurance payable for which there is no designated beneficiary shall be payable to the estate of the employee or member, except that the insurer may in such case, at its option, pay such insurance to any one or more of the following surviving relatives of the employee or member: Wife, husband, mother, father, child or children, brothers or sisters; and except that payment of benefits for expenses incurred on account of hospitalization or medical or surgical aid, as provided in section 2811, may be made by the insurer to the hospital or other person or persons furnishing such aid. Payment so made shall discharge the insurer's obligation with respect to the amount of insurance so paid.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2811 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2811. Payment of expenses

 §2811. Payment of expenses Any policy or contract of group health insurance may include provisions for the payment by the insurer of benefits for expenses incurred, by the employee or other member of the insured group, on account of hospitalization or medical or surgical aid for the employee, the employee's spouse, the employee's child or children, or other persons chiefly dependent upon the employee for support and maintenance.   [RR 2021, c. 1, Pt. B, §244 (COR).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). RR 2021, c. 1, Pt. B, §244 (COR).
24-A ME Rev Stat § 2812 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2812. Readjustment of premium rate (REPEALED)

 §2812. Readjustment of premium rate (REPEALED)SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1969, c. 177, §52 (AMD). PL 1991, c. 200, §D3 (RP).
24-A ME Rev Stat § 2812-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2812-A. Dividends and experience refunds

 §2812-A. Dividends and experience refunds The following requirements apply to all group health insurance with the exception of insurance in which the policyholder is subject to the fiduciary standards of the federal Employee Retirement Income Security Act of 1974, ERISA, 29 United States Code, Section 1001‑1381 (1975).   [PL 1991, c. 200, Pt. D, §4 (NEW).]1.  Refunds.  The amount by which any dividend, experience refund or rate reduction exceeds the amount of premium contributed by the group policyholder for the same period must be refunded to the employees, members or debtors in proportion to their premium contributions for that period, except as provided in subsection 2.   [PL 1991, c. 200, Pt. D, §4 (NEW).] 2.  Refund amounts less than $25 per employee, member or debtor.  If the refunds required by subsection 1 would average less than $25 per employee, member or debtor, then the group policyholder may request approval from the superintendent to apply those amounts in a different manner. The superintendent shall approve the request if, in the superintendent's opinion, the manner of application proposed would be for the sole benefit of insured employees, members or debtors.   [PL 1991, c. 200, Pt. D, §4 (NEW).] SECTION HISTORY PL 1991, c. 200, §D4 (NEW).
24-A ME Rev Stat § 2814 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2814. Blanket health insurance; payments; beneficiaries

 §2814. Blanket health insurance; payments; beneficiaries All benefits under any blanket health insurance policy are payable to the person insured, or to the person's designated beneficiary or beneficiaries, or to the person's estate, as are specified in the policy, except that if the person insured be a minor, such benefits may be made payable to the person's parent, guardian or other person actually supporting the person, or to a person or persons chiefly dependent upon the person for support and maintenance.   [RR 2021, c. 1, Pt. B, §245 (COR).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). RR 2021, c. 1, Pt. B, §245 (COR).
24-A ME Rev Stat § 2815 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2815. Legal liability of policyholders

 §2815. Legal liability of policyholders Nothing contained in this chapter shall be deemed to affect the legal liability of policyholders for the death of or injury to any member of any such group.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2816 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2816. Requirements

 §2816. Requirements No policy of group or blanket health insurance shall, except as provided in section 2829, be delivered or issued for delivery in this State, unless the policy contains in substance each and all of the provisions set forth in sections 2817 to 2828, or provisions which in the opinion of the superintendent are more favorable to the holders of such certificates or not less favorable to the holders of such certificates and more favorable to policyholders. Insurers offering policies under this chapter shall offer to certificate holders the right of review and arbitration set forth in section 2747, subsection 1, with respect to denials of medical expense reimbursement benefits based upon the grounds set forth in section 2747, subsection 2, except that the requirement of section 2747, subsection 1 shall not apply to certificate holders in groups subject to the United States Employee Retirement Income Security Act of 1974, Public Law 93-406, as amended, or to any policy or certificate holder to whom the insurer voluntarily extends a review similar to that which it provides to persons insured under group policies subject to that Act.   [PL 1981, c. 698, §110 (AMD).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1969, c. 177, §53 (AMD). PL 1981, c. 205, §3 (AMD). PL 1981, c. 698, §110 (AMD).
24-A ME Rev Stat § 2817 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2817. Applicant's statements; waivers, amendments

 §2817. Applicant's statements; waivers, amendments There shall be a provision that no statement made by the applicant for insurance shall avoid the insurance or reduce benefits thereunder unless contained in the written application signed by the applicant; and a provision that no agent has authority to change the policy or to waive any of its provisions; and that no change in the policy shall be valid unless approved by an officer of the insurer and evidenced by indorsement on the policy, or by amendment to the policy signed by the policyholder and the insurer.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2818 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2818. Statements in application

 §2818. Statements in application There shall be a provision that all statements contained in any such application for insurance shall be deemed representations and not warranties.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2819 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2819. New employees, members

 §2819. New employees, members There shall be a provision that all new employees or new members, as the case may be, in the groups or classes eligible for such insurance must be added to such groups or classes for which they are respectively eligible.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2820 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2820. Renewal of policy

 §2820. Renewal of policy There shall be a provision stating the conditions under which the insurer may decline to renew the policy.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2821 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2821. Individual certificates

 §2821. Individual certificates Except in the case of blanket health insurance, a provision that the insurer shall issue to the policyholder, for delivery to each member of the insured group, an individual certificate or printed information setting forth in summary form a statement of the essential features of the insurance coverage of such employee or such member and in substance the provisions of sections 2821 to 2828. The insurer shall also provide for distribution by the policyholder to each member of the insured group a statement, where applicable, setting forth to whom the benefits under such policy are payable. If dependents are included in the coverage, only one certificate or printed summary need be issued for each family unit.   [PL 1975, c. 183, §2 (AMD).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1969, c. 177, §54 (AMD). PL 1975, c. 183, §2 (AMD).
24-A ME Rev Stat § 2822 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2822. Age limits

 §2822. Age limits There shall be a provision specifying the ages, if any there be, to which the insurance provided therein shall be limited; and the ages, if any there be, for which additional restrictions are placed on benefits and the additional restrictions placed on the benefits at such ages.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2823 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2823. Notice of claim

 §2823. Notice of claim There shall be a provision that written notice of sickness or of injury must be given to the insurer within 30 days after the date when such sickness or injury occurred. Failure to give notice within such time shall not invalidate nor reduce any claim, if it shall be shown not to have been reasonably possible to give such notice and that notice was given as soon as was reasonably possible.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2823-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2823-A. Explanation and notice to parent

 §2823-A. Explanation and notice to parent If the insured is covered as a dependent child, and if the insurer is so requested by a parent of the insured, the insurer shall provide that parent with:   [PL 2009, c. 244, Pt. B, §2 (AMD).]1.  Payment or denial of claim.  An explanation of the payment or denial of any claim filed on behalf of the insured, except to the extent that the insured has the right to withhold consent and does not affirmatively consent to notifying the parent;   [PL 2009, c. 244, Pt. B, §2 (AMD).] 2.  Change in terms and conditions.  An explanation of any proposed change in the terms and conditions of the policy; or   [PL 1989, c. 556, Pt. D, §3 (NEW).] 3.  Notice of lapse.  Reasonable notice that the policy may lapse, but only if the parent has provided the insurer with the address at which the parent may be notified.   [PL 1989, c. 556, Pt. D, §3 (NEW).] In addition, any parent who is able to provide the information necessary for the insurer to process a claim must be permitted to authorize the filing of any claims under the policy.   [PL 2009, c. 244, Pt. B, §2 (AMD).]SECTION HISTORY PL 1989, c. 556, §D3 (NEW). PL 2009, c. 244, Pt. B, §2 (AMD).
24-A ME Rev Stat § 2823-B (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2823-B. Standardized claim forms

 §2823-B. Standardized claim forms All insurers providing group medical expense insurance on an expense-incurred basis providing payment or reimbursement for diagnosis or treatment of a condition or a complaint by a licensed health care practitioner must accept the current standardized claim form for professional services approved by the Federal Government and submitted electronically. All insurers providing group medical expense insurance on an expense-incurred basis providing payment or reimbursement for diagnosis or treatment of a condition or a complaint by a licensed hospital must accept the current standardized claim form for professional or facility services, as applicable, approved by the Federal Government and submitted electronically. An insurer may not be required to accept a claim submitted on a form other than the applicable form specified in this section and may not be required to accept a claim that is not submitted electronically, except from a health care practitioner who is exempt pursuant to Title 24, section 2985. All services provided by a health care practitioner in an office setting must be submitted on the standardized federal form used by noninstitutional providers and suppliers. Services in a nonoffice setting may be billed as negotiated between the insurer and health care practitioner. For purposes of this section, "office setting" means a location where the health care practitioner routinely provides health examinations, diagnosis and treatment of illness or injury on an ambulatory basis whether or not the office is physically located within a facility.   [PL 2005, c. 97, §3 (AMD).]SECTION HISTORY PL 1993, c. 477, §D11 (NEW). PL 1993, c. 477, §F1 (AFF). PL 2003, c. 218, §7 (AMD). PL 2003, c. 469, §D7 (AMD). PL 2003, c. 469, §D9 (AFF). PL 2005, c. 97, §3 (AMD).
24-A ME Rev Stat § 2824 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2824. Proof of loss

 §2824. Proof of loss There shall be a provision that in the case of claim for loss of time for disability, written proof of such loss must be furnished to the insurer within 30 days after the commencement of the period for which the insurer is liable, and that subsequent written proofs of the continuance of such disability must be furnished to the insurer at such intervals as the insurer may reasonably require, and that in the case of claim for any other loss, written proof of such loss must be furnished to the insurer within 90 days after the date of such loss. Failure to furnish such proof within such time shall not invalidate nor reduce any claim, if it shall be shown not to have been reasonably possible to furnish such proof and that such proof was furnished as soon as was reasonably possible.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2825 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2825. Forms for proof of loss

 §2825. Forms for proof of loss There shall be a provision that the insurer will furnish to the policyholder such forms as are usually furnished by it for filing proof of loss. If such forms are not furnished before the expiration of 15 days after the insurer received notice of any claim under the policy, the person making such claim shall be deemed to have complied with the requirements of the policy as to proof of loss upon submitting within the time fixed in the policy for filing proof of loss, written proof covering the occurrence, character and extent of the loss for which claim is made.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2826 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2826. Examination, autopsy

 §2826. Examination, autopsy There shall be a provision that the insurer shall have the right and opportunity to examine the person of the insured when and so often as it may reasonably require during the pendency of claim under the policy and also the right and opportunity to make an autopsy in case of death where it is not prohibited by law.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2827 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2827. Time for payment of benefits

 §2827. Time for payment of benefits There shall be a provision that all benefits payable under the policy, other than benefits for loss of time, will be payable not more than 60 days after receipt of proof, and that, subject to due proof of loss, all accrued benefits payable under the policy for loss of time will be paid not later than at the expiration of each period of 30 days during the continuance of the period for which the insurer is liable, and that any balance remaining unpaid at the termination of such period will be paid immediately upon receipt of such proof.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2827-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2827-A. Assignment of benefits

 §2827-A. Assignment of benefits All policies and certificates providing benefits for medical or dental care on an expense-incurred basis must contain a provision permitting the insured to assign benefits for such care to the provider of the care. An assignment of benefits under this section does not affect or limit the payment of benefits otherwise payable under the policy or certificate.   [PL 1999, c. 21, §3 (AMD).]SECTION HISTORY PL 1997, c. 604, §E3 (NEW). PL 1999, c. 21, §3 (AMD).