reglab/housing_qa huggingface dataset:
24-A ME Rev Stat § 2736 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2736. Rate filings on individual health insurance policies

 §2736. Rate filings on individual health insurance policies 1.  Filing of rate information.  Every insurer shall file for approval by the superintendent every rate, rating formula, classification of risks and every modification of any formula or classification that it proposes to use in connection with individual health insurance policies and certain group policies specified in section 2701. If the filing applies to individual health plans as defined in section 2736‑C, the insurer shall simultaneously file a copy with the Attorney General. Every such filing must state the effective date of the filing. Every such filing must be made not less than 60 days in advance of the stated effective date, unless the 60-day requirement is waived by the superintendent, and the effective date may be suspended by the superintendent for a period of time not to exceed 30 days. A filing required under this section must be made electronically in a format required by the superintendent unless exempted by rule adopted by the superintendent. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A.   [PL 2009, c. 439, Pt. C, §1 (RPR).] 2.  Filing; information.  When a filing is not accompanied by the information upon which the insurer supports such filing, or the superintendent does not have sufficient information to determine whether such filing meets the requirements that rates not be excessive, inadequate or unfairly discriminatory, the superintendent shall require the insurer to furnish the information upon which it supports the filing. A filing and all supporting information, except for protected health information required to be kept confidential by state or federal statute and descriptions of the amount and terms or conditions or reimbursement in a contract between an insurer and a 3rd party, are public records notwithstanding Title 1, section 402, subsection 3, paragraph B and become part of the official record of any hearing held pursuant to section 2736-A.   [PL 2009, c. 439, Pt. C, §2 (AMD).] 3.  Criteria for special rate hearings.   [PL 2009, c. 244, Pt. C, §5 (RP).] 4.  Special rate hearing.   [PL 2009, c. 244, Pt. C, §6 (RP).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD). PL 1977, c. 493, §3 (RPR). PL 1979, c. 558, §§6,7 (AMD). PL 1985, c. 648, §10 (AMD). PL 1997, c. 344, §8 (AMD). PL 2001, c. 432, §§5,6 (AMD). PL 2003, c. 428, §F2 (AMD). PL 2003, c. 469, §§E9,10 (AMD). PL 2007, c. 629, Pt. M, §§1, 2 (AMD). PL 2009, c. 14, §4 (AMD). PL 2009, c. 244, Pt. C, §§5, 6 (AMD). PL 2009, c. 244, Pt. G, §1 (AMD). PL 2009, c. 439, Pt. C, §§1, 2 (AMD).
24-A ME Rev Stat § 2736-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2736-A. Hearing

 §2736-A. Hearing If at any time the superintendent has reason to believe that a filing does not meet the requirements that rates not be excessive, inadequate or unfairly discriminatory or that the filing violates any of the provisions of chapter 23, the superintendent shall cause a hearing to be held. If a filing proposes an increase in rates in an individual health plan as defined in section 2736‑C, the superintendent shall cause a hearing to be held at the request of the Attorney General. In any hearing conducted under this section, the insurer has the burden of proving rates are not excessive, inadequate or unfairly discriminatory.   [PL 2011, c. 364, §2 (AMD).]Hearings held under this section must conform to the procedural requirements set forth in the Maine Administrative Procedure Act, Title 5, chapter 375, subchapter 4.   [PL 2003, c. 469, Pt. E, §11 (AMD).]SECTION HISTORY PL 1977, c. 493, §4 (NEW). PL 1977, c. 694, §422 (AMD). PL 1979, c. 330, §2 (AMD). PL 1979, c. 558, §8 (RPR). PL 2003, c. 469, §E11 (AMD). PL 2007, c. 629, Pt. M, §3 (AMD). PL 2009, c. 439, Pt. C, §3 (AMD). PL 2011, c. 364, §2 (AMD).
24-A ME Rev Stat § 2736-B (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2736-B. Order

 §2736-B. Order The superintendent shall issue an order or decision within 30 days after the close of the hearing, or of any rehearing or reargument or within such other period as the superintendent for good cause may require, but not to exceed an additional 30 days. In the order or decision, the superintendent shall either approve or disapprove the rate filing. If the superintendent disapproves the rate filing, the superintendent shall establish the date on which the filing is no longer effective, specify the filing the superintendent would approve and authorize the insurer to submit a new filing in accordance with the terms of the order or decision.   [PL 1989, c. 269, §14 (AMD).]SECTION HISTORY PL 1979, c. 558, §9 (NEW). PL 1989, c. 269, §14 (AMD).
24-A ME Rev Stat § 2737 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2737. Noncancellable disability insurance defined

 §2737. Noncancellable disability insurance defined "Noncancellable disability insurance" means insurance against disability resulting from sickness, ailment or bodily injury, but not including insurance solely against accidental injury, under any contract which does not give the insurer the option to cancel or otherwise terminate the contract at or after one year from its effective date or renewal date.   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 2738 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2738. Notice as to renewability

 §2738. Notice as to renewability The superintendent shall have the right to make the following requirements:   [PL 1973, c. 585, §12 (AMD).]1.  When a policy has neither a brief description nor a separate statement printed on the first page and on the filing back, referring to the renewal conditions of the policy, a separately captioned provision, setting forth the conditions under which the policy may be renewed, must appear on the first page of the policy. The caption shall be clear and definite and shall be approved by the superintendent; but any one of the following captions is acceptable:"RENEWAL SUBJECT TO CONSENT OF COMPANY. RENEWAL SUBJECT TO COMPANY CONSENT. RENEWABLE AT OPTION OF COMPANY."  [PL 1973, c. 585, §12 (AMD).] 2.  If the policy is not renewable, a separate, appropriately captioned provision on the first page of the policy shall so state.   [PL 1969, c. 132, §1 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD).
24-A ME Rev Stat § 2739 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2739. Lapse of policy, advance notice; limitation of action

 §2739. Lapse of policy, advance notice; limitation of action An individual policy of health insurance issued or delivered in this State, except a policy which by its terms is renewable or continuable with the insurer's consent, or except a policy the premiums for which are payable monthly or at shorter intervals, may not terminate or lapse for nonpayment of any premium until the expiration of 3 months from the due date of such premium, unless the insurer, within not less than 10 nor more than 45 days prior to such due date, has mailed, postage prepaid, duly addressed to the insured at the insured's last address shown by the insurer's records, a notice showing the amount of such premium and its due date. If such a notice is not so sent, the insured may pay the premium in default at any time within such period of 3 months. The affidavit of any officer, clerk or agent of the insurer, or of any other person authorized to mail such notice, that the notice required by this section has been duly mailed by the insurer in the manner required is prima facie evidence that such notice was duly given. An action may not be maintained on any policy to which this section applies and that has lapsed for nonpayment of any premium unless such action is commenced within 2 years from the due date of such premium.   [RR 2021, c. 1, Pt. B, §241 (COR).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). RR 2021, c. 1, Pt. B, §241 (COR).
24-A ME Rev Stat § 2740 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2740. Franchise health insurance law (REPEALED)

 §2740. Franchise health insurance law (REPEALED)SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 205 (AMD). PL 1995, c. 332, §C1 (RP).
24-A ME Rev Stat § 2741 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2741. Maternity benefits for unmarried women policyholders and the minor dependents of policyholders with dependent or family coverage required

 §2741. Maternity benefits for unmarried women policyholders and the minor dependents of policyholders with dependent or family coverage required All health insurance policies and plans shall provide, at appropriate rates, the same maternity benefits for unmarried women policyholders and the minor dependents of policyholders with dependent or family coverage under the same terms and conditions as such maternity coverage is provided to married policyholders or the wives of policyholders with maternity coverage. This requirement shall apply to all insurance policies and plans issued or renewed after the effective date of this Act.   [PL 1975, c. 276, §2 (NEW).]SECTION HISTORY PL 1975, c. 276, §2 (NEW). PL 1975, c. 428, §2 (NEW). PL 1975, c. 561 (NEW). PL 1975, c. 770, §§102,103 (RP).
24-A ME Rev Stat § 2742-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2742-A. Extension of coverage for dependent children

 §2742-A. Extension of coverage for dependent children Notwithstanding section 2703, subsection 3, an individual 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, §1 (NEW).]SECTION HISTORY PL 2005, c. 532, §1 (NEW).
24-A ME Rev Stat § 2742-B (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2742-B. Mandatory offer to extend coverage for dependent children up to 26 years of age

 §2742-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 an individual health insurance policy.   A. [PL 2019, c. 5, Pt. A, §8 (RP).] B. [PL 2019, c. 5, Pt. A, §8 (RP).] C. [PL 2019, c. 5, Pt. A, §8 (RP).] D. [PL 2007, c. 514, §3 (RP).] [PL 2019, c. 5, Pt. A, §8 (AMD).] 2.  Offer of coverage.  Notwithstanding section 2703, subsection 3, an individual health insurance policy that offers coverage for a dependent child must offer such coverage, at the option of the policyholder, until the dependent child attains 26 years of age.   [PL 2019, c. 5, Pt. A, §8 (AMD).] 3.  Notice.   [PL 2007, c. 514, §5 (NEW); MRSA T. 24-A §2742-B, sub-§3 (RP).] SECTION HISTORY PL 2007, c. 115, §1 (NEW). PL 2007, c. 115, §5 (AFF). PL 2007, c. 514, §§1-5 (AMD). PL 2019, c. 5, Pt. A, §8 (AMD).
24-A ME Rev Stat § 2743 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2743. Newborn children coverage

 §2743. Newborn children coverage All individual health insurance policies providing coverage on an expense-incurred basis must provide that health insurance benefits are payable with respect to a newly born child of the insured or subscriber from the moment of birth.   [PL 1997, c. 604, Pt. C, §2 (AMD).]The coverage for newly born children must consist of coverage of injury, 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, §2 (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 2743‑A must be paid regardless of whether coverage under this section is elected.   [PL 1997, c. 604, Pt. C, §2 (AMD).]The requirements of this section apply to all policies delivered or issued for delivery in this State more than 120 days after the effective date of this Act.   [PL 1997, c. 604, Pt. C, §2 (AMD).]SECTION HISTORY PL 1975, c. 770, §104 (NEW). PL 1995, c. 332, §N2 (AMD). PL 1997, c. 604, §C2 (AMD).
24-A ME Rev Stat § 2743-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2743-A. Maternity and routine newborn care

 §2743-A. Maternity and routine newborn care An insurer that issues individual contracts 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 2001, c. 258, Pt. A, §2 (AMD).]SECTION HISTORY PL 1995, c. 615, §2 (NEW). PL 2001, c. 258, §A2 (AMD).
24-A ME Rev Stat § 2745-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2745-A. Screening mammograms

 §2745-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, §1 (AMD); PL 2007, c. 153, §5 (AFF).] 2.  Required coverage.  All individual insurance policies that cover radiologic procedures, except those designed to cover only specific diseases, accidental injury or dental procedures, 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, §3 (RP); PL 1997, c. 408, §8 (AFF).]B.   [PL 1997, c. 408, §3 (RP); PL 1997, c. 408, §8 (AFF).][PL 1997, c. 408, §3 (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, §1 (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, §6 (AMD).] SECTION HISTORY PL 1989, c. 875, §I3 (NEW). PL 1991, c. 156, §1 (AMD). PL 1991, c. 701, §6 (AMD). PL 1997, c. 408, §3 (AMD). PL 1997, c. 408, §8 (AFF). PL 2003, c. 689, §B6 (REV). PL 2007, c. 153, §1 (AMD). PL 2007, c. 153, §5 (AFF).
24-A ME Rev Stat § 2745-B (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2745-B. Acupuncture services

 §2745-B. Acupuncture services All individual insurance policies providing coverage for acupuncture must provide coverage for those services when performed by an acupuncturist licensed pursuant to Title 32, chapter 113‑B, subchapter II, under the same conditions that apply to the services of a licensed physician.   [PL 1995, c. 671, §9 (AMD).]SECTION HISTORY PL 1991, c. 647, §2 (NEW). PL 1995, c. 671, §9 (AMD).
24-A ME Rev Stat § 2745-C (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2745-C. Coverage for breast cancer treatment

 §2745-C. Coverage for breast cancer treatment 1.  Inpatient care.  All individual health policies providing coverage for medical and surgical benefits, except accidental injury, specified disease, hospital indemnity, Medicare supplement, long-term care and other limited benefit health insurance policies and contracts, must ensure that inpatient coverage with respect to the treatment of breast cancer is provided for a period of time determined by the attending physician, after providing notice to the patient regarding the coverage required by this subsection and in consultation with the patient, to be medically appropriate following a mastectomy, a lumpectomy or a lymph node dissection for the treatment of breast cancer.   Nothing in this subsection may be construed to require the provision of inpatient coverage if the attending physician and patient determine that a shorter period of hospital stay is appropriate.   In implementing the requirements of this subsection, an individual health policy may not modify the terms and conditions of coverage based on the determination by any enrollee to request less than the minimum coverage required under this subsection.   All individual health policies must provide written notice to each enrollee under the contract regarding the coverage required by this subsection. The notice must be prominently positioned in any literature or correspondence made available or distributed by the plan and must be transmitted in the next mailing made by the plan to the enrollee or as part of any yearly information packet sent to the enrollee, whichever is earlier. The notice must also be made available to any physician participating in the insurer's provider network.   [PL 2015, c. 227, §2 (AMD); PL 2015, c. 227, §5 (AFF).] 2.  Reconstruction.  All individual health policies providing coverage for mastectomy surgery must provide coverage for reconstruction of the breast on which surgery has been performed and surgery and reconstruction of the other breast to produce a symmetrical appearance if the patient elects reconstruction and in the manner chosen by the patient and the physician.   [PL 1997, c. 408, §4 (NEW); PL 1997, c. 408, §8 (AFF).] SECTION HISTORY RR 1995, c. 1, §15 (COR). PL 1995, c. 295, §3 (NEW). PL 1995, c. 369, §2 (NEW). PL 1997, c. 408, §4 (RPR). PL 1997, c. 408, §8 (AFF). PL 2015, c. 227, §2 (AMD). PL 2015, c. 227, §5 (AFF).
24-A ME Rev Stat § 2745-D (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 33: HEALTH INSURANCE CONTRACTS|24-A §2745-D. Medical food coverage for inborn error of metabolism

 §2745-D. Medical food coverage for inborn error of metabolism 1.  Inborn error of metabolism; special modified low-protein food product.  As used in this section, "inborn error of metabolism" means a genetically determined biochemical disorder in which a specific enzyme defect produces a metabolic block that may have pathogenic consequences at birth or later in life. As used in this section, "special modified low-protein food product" means food formulated to reduce the protein content to less than one gram of protein per serving and does not include foods naturally low in protein.   [PL 1995, c. 369, §2 (NEW).] 2.  Required coverage.  All individual insurance policies and contracts, except accidental injury, specified disease, hospital indemnity, Medicare supplement, long-term care and other limited benefit health insurance policies and contracts, must provide coverage for metabolic formula and special modified low-protein food products that have been prescribed by a licensed physician for a person with an inborn error of metabolism. The policies and contracts must reimburse:   A. For metabolic formula; and   [PL 1995, c. 369, §2 (NEW).]B. Up to $3,000 per year for special modified low-protein food products.   [PL 1995, c. 369, §2 (NEW).][PL 1995, c. 369, §2 (NEW).] 3.  Application.  The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 1996. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.   [PL 1995, c. 369, §2 (NEW).] SECTION HISTORY RR 1995, c. 1, §15 (RNU). PL 1995, c. 369, §2 (NEW).