reglab/housing_qa huggingface dataset:
24-A ME Rev Stat § 1262 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 15: ADMINISTRATION OF DEPOSITS|24-A §1262. Deficiency of deposit

 §1262. Deficiency of deposit If for any reason the market value of securities of an insurer held on deposit in this State as required under this Title falls below the required amount, the insurer shall promptly deposit other or additional assets eligible for deposit sufficient to cure the deficiency. If the insurer has failed to cure the deficiency within 20 days after receipt of notice thereof by registered mail from the superintendent, the superintendent shall forthwith revoke the insurer's certificate of authority.   [PL 1973, c. 585, §12 (AMD).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD).
24-A ME Rev Stat § 1902 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18: INSURANCE ADMINISTRATORS|24-A §1902. License required

 §1902. License required A person may not act as or profess to be an administrator after August 1, 1990, unless licensed under this chapter. An administrator doing business in this State on August 1, 1990, shall apply for a license by November 1, 1990. In addition to any other penalty that may be imposed for violation of this Title, any person violating this section shall, upon conviction, be punished by a fine of not less than $100 nor more than $1,000 or by imprisonment for less than one year, or both.   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]An administrator licensed under this chapter on or before December 31, 2003 shall submit information by March 21, 2004 as to the types of business conducted by that administrator in this State on a form prescribed by the superintendent.   [PL 2003, c. 469, Pt. E, §3 (NEW).]SECTION HISTORY PL 1989, c. 846, §§D2,E4 (NEW). PL 2003, c. 469, §E3 (AMD).
24-A ME Rev Stat § 1903 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18: INSURANCE ADMINISTRATORS|24-A §1903. Application

 §1903. Application An applicant for a license shall file with the superintendent an application, on a form prescribed by the superintendent, that must include or have attached the following:   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]1.  The names, addresses and official positions of the individuals who are responsible for the conduct of the affairs of the administrator, including, but not limited to, all members of the board of directors, board of trustees, executive committee, or other governing board or committee, the principal officers in the case of a corporation or the partners in the case of a partnership;   [PL 2003, c. 469, Pt. E, §4 (AMD).] 2.  An application fee, as specified in section 601, that the superintendent shall apply toward the initial administrator annual fee if an administrator's license is granted to the applicant; and   [PL 2003, c. 469, Pt. E, §4 (AMD).] 3.  The specific type of business in which the 3rd-party administrator will or intends to engage.   [PL 2003, c. 469, Pt. E, §5 (NEW).] SECTION HISTORY PL 1989, c. 846, §§D2,E4 (NEW). PL 2003, c. 469, §§E4,5 (AMD).
24-A ME Rev Stat § 1904 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18: INSURANCE ADMINISTRATORS|24-A §1904. Bond requirements for administrators

 §1904. Bond requirements for administrators 1.  Every applicant for an administrator's license shall file with the application, and shall maintain in force while licensed, a fidelity bond, and at the superintendent's discretion, a surety bond, in favor of the Treasurer of State, for the benefit of covered persons or plan sponsors as their interest may appear, executed by a surety company authorized to do business in this State and payable to any party injured under the terms of the bond. The bond must be continuous in form and in one of the following amounts:   A. For an administrator that maintains an ATF but does not maintain a CASA, the greater of $50,000 or 5% of contributions and premiums projected to be received or collected in the ATF for the following plan year from residents of the State, but not to exceed $1,000,000;   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]B. For an administrator that maintains a CASA but does not maintain an ATF, the greater of $50,000 or 5% of the claims and claim expenses projected to be held in the CASA for the following year to pay claims and claim expenses for residents of the State, but not to exceed $1,000,000; or   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]C. For an administrator that maintains an ATF and a CASA, the greater of $50,000 or 5% of contributions and premiums projected to be received or collected in the ATF for the following plan year from residents of the State plus 5% of the claims and claim expenses projected to be held in the CASA accounts for the following year to pay claims and claim expenses for residents of the State, but not to exceed $1,000,000.   [PL 1993, c. 171, Pt. A, §1 (AMD).]This subsection applies to an administrator who is required to maintain funds in a fiduciary capacity as set forth in section 1909.   [PL 1995, c. 329, §27 (AMD).] 2.  The bond must remain in force and effect until the surety is released from liability by the superintendent or until the bond is cancelled by the surety. The surety may cancel the bond and be released from further liability under the bond upon 30 days' written notice in advance to the superintendent. The cancellation does not affect any liability incurred or accrued under the bond before the 30-day period expires. Upon receiving any notice of cancellation, the superintendent shall immediately notify the licensee.   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] 3.  The administrator's license automatically terminates if the bond required by this section is not in force. Within 30 days after the bond ceases to be in force, the administrator shall return the license to the superintendent for cancellation.   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] SECTION HISTORY PL 1989, c. 846, §§D2,E4 (NEW). PL 1993, c. 171, §A1 (AMD). PL 1995, c. 329, §27 (AMD).
24-A ME Rev Stat § 1905 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18: INSURANCE ADMINISTRATORS|24-A §1905. License

 §1905. License 1.  Upon receipt of a complete application for an administrator license, the superintendent shall investigate, to the extent the superintendent considers advisable, the applicant's experience, background and fitness for the license. The superintendent may obtain a credit and investigative report relative to the applicant from a recognized and established independent investigation and reporting agency. The superintendent may establish from time to time a reasonable uniform flat amount that the applicant must pay for the report. The report cost must be included with the application. The contents of the report are confidential.   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] 2.  If the superintendent finds that the applicant is qualified for an administrator license, the superintendent shall promptly issue the license, which identifies the types of business in which the applicant may engage; otherwise the superintendent shall refuse to issue the license and promptly notify the applicant.   [PL 2003, c. 469, Pt. E, §6 (AMD).] 3.  Sections 1417 and 1418 apply to licenses issued under this chapter.   [PL 1997, c. 457, §29 (AMD); PL 1997, c. 457, §55 (AFF).] 4.  Unless revoked or suspended under section 1907, an administrator license remains in effect as long as the holder of the license maintains in force and effect the bond required by section 1904 and pays the annual fee required by section 601 before the anniversary date of the license.   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] 5.  An administrator shall submit an application to amend its license if the administrator desires to amend the types of business on its then-current license.   [PL 2003, c. 469, Pt. E, §7 (NEW).] SECTION HISTORY PL 1989, c. 846, §§D2,E4 (NEW). PL 1997, c. 457, §29 (AMD). PL 1997, c. 457, §55 (AFF). PL 2003, c. 469, §§E6,7 (AMD).
24-A ME Rev Stat § 1907 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18: INSURANCE ADMINISTRATORS|24-A §1907. License suspension, revocation or denial

 §1907. License suspension, revocation or denial Any license issued under this chapter may be suspended or revoked after notice to the licensee and an opportunity for hearing and any application for license may be denied after notice and opportunity for hearing:   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]1.  For any of the grounds for suspension or revocation of a license set forth in section 1417; or   [PL 1997, c. 457, §31 (AMD); PL 1997, c. 457, §55 (AFF).] 2.  If the licensee or applicant:   A. Is using any method or practice in conducting business that renders further transaction of business in this State hazardous or injurious to covered individuals or the public;   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]B. Is affiliated with and is under the same general management as another administrator that transacts business in this State without being licensed under this chapter; or   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]C. Has failed to report a conviction as required by section 1908.   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).][PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] SECTION HISTORY PL 1989, c. 846, §§D2,E4 (NEW). PL 1997, c. 457, §31 (AMD). PL 1997, c. 457, §55 (AFF).
24-A ME Rev Stat § 1908 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18: INSURANCE ADMINISTRATORS|24-A §1908. Criminal convictions

 §1908. Criminal convictions Any administrator and any individual listed on the application, as required by section 1903, who is convicted of a crime punishable by imprisonment for more than one year shall report that conviction to the superintendent within 30 days after judgment is entered. Within that 30-day period, the administrator shall also provide the superintendent with a copy of the judgment and any commitment order and any other relevant documents relating to disposition of the criminal action.   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]SECTION HISTORY PL 1989, c. 846, §§D2,E4 (NEW).
24-A ME Rev Stat § 1910 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18: INSURANCE ADMINISTRATORS|24-A §1910. Unauthorized activities

 §1910. Unauthorized activities Nothing in this chapter may be construed to permit any person or entity to receive or collect charges, contributions or premiums for, or adjust or settle claims in connection with, any type of life or accident or health benefit, unless the person or entity is authorized through the insurance laws of a state or the Employee Retirement Income Security Act of 1974, 29 United States Code, Section 1001, et seq. as amended, to provide those benefits.   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]SECTION HISTORY PL 1989, c. 846, §§D2,E4 (NEW).
24-A ME Rev Stat § 1911 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18: INSURANCE ADMINISTRATORS|24-A §1911. Audits and examinations

 §1911. Audits and examinations The superintendent may designate examiners or consultants, as appropriate, to perform an audit of an administrator when the superintendent considers an audit necessary. Administrators shall make all records and books of account available to the examiners or consultants, and shall otherwise facilitate the performance of the audit. All claims information respecting individual claimants must be kept confidential.   [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]SECTION HISTORY PL 1989, c. 846, §§D2,E4 (NEW).
24-A ME Rev Stat § 1912 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18: INSURANCE ADMINISTRATORS|24-A §1912. Standardized claim forms

 §1912. Standardized claim forms All administrators who administer claims and who provide 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 administrators who administer claims and who provide 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 administrator 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 administrator 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, §1 (AMD).]SECTION HISTORY PL 1993, c. 477, §D8 (NEW). PL 1993, c. 477, §F1 (AFF). PL 2003, c. 218, §2 (AMD). PL 2003, c. 469, §D3 (AMD). PL 2003, c. 469, §D9 (AFF). PL 2005, c. 97, §1 (AMD).
24-A ME Rev Stat § 1913 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18: INSURANCE ADMINISTRATORS|24-A §1913. Registration of pharmacy benefits managers (REPEALED)

 §1913. Registration of pharmacy benefits managers (REPEALED)SECTION HISTORY PL 2009, c. 581, §4 (NEW). PL 2011, c. 443, §4 (RPR). PL 2019, c. 469, §5 (RP). PL 2019, c. 469, §9 (AFF).
24-A ME Rev Stat § 1951 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18-A: PRIVATE PURCHASING ALLIANCES|24-A §1951. Definitions

 §1951. Definitions As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings.   [PL 1995, c. 673, Pt. A, §3 (NEW).]1.  Carrier.  "Carrier" means any insurance company, nonprofit hospital and medical service organization or health maintenance organization authorized to issue health plans in this State. For the purposes of this chapter, carriers that are affiliated companies or that are eligible to file consolidated tax returns are treated as one carrier and any restrictions or limitations imposed by this chapter apply as if all health plans delivered or issued for delivery in this State by affiliated carriers were issued by one carrier. For purposes of this chapter, health maintenance organizations are treated as separate organizations from affiliated insurance companies and nonprofit hospital and medical service organizations.   [PL 1995, c. 673, Pt. A, §3 (NEW).] 2.  Private purchasing alliance.  "Private purchasing alliance" or "alliance" means a corporation established under former Title 13‑A, Title 13‑B or Title 13‑C to provide health insurance to its members through one or more participating carriers.   [PL 2003, c. 428, Pt. H, §1 (AMD).] SECTION HISTORY PL 1995, c. 673, §A3 (NEW). PL 1997, c. 616, §1 (AMD). RR 2001, c. 2, §B42 (COR). RR 2001, c. 2, §B58 (AFF). PL 2001, c. 369, §1 (AMD). PL 2003, c. 428, §H1 (AMD).
24-A ME Rev Stat § 1952 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18-A: PRIVATE PURCHASING ALLIANCES|24-A §1952. Licensure

 §1952. Licensure A private purchasing alliance may not market, sell, offer or arrange for a package of one or more health benefit plans underwritten by one or more carriers without first being licensed by the superintendent. The superintendent shall specify by rule standards and procedures for the issuance and renewal of licenses for private purchasing alliances. A rule may require an application fee of not more than $400 and an annual license fee of not more than $100. A license may not be issued until the rulemaking required by this chapter has been undertaken and all required rules are in effect. Dirigo Health, as established in chapter 87, is exempt from the licensure requirements of this section as an independent executive agency of the State.   [PL 2003, c. 469, Pt. E, §8 (AMD).]SECTION HISTORY PL 1995, c. 673, §A3 (NEW). PL 2003, c. 428, §H2 (AMD). PL 2003, c. 469, §E8 (AMD).
24-A ME Rev Stat § 1953 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18-A: PRIVATE PURCHASING ALLIANCES|24-A §1953. Powers

 §1953. Powers In addition to the powers granted in Title 13‑B or Title 13‑C, an alliance may do any of the following:   [RR 2001, c. 2, Pt. B, §43 (COR); RR 2001, c. 2, Pt. B, §58 (AFF).]1.  Membership fees.  Set reasonable fees for membership in the alliance for financing reasonable and necessary costs incurred in administering the alliance;   [PL 1995, c. 673, Pt. A, §3 (NEW).] 2.  Premium collection.  Provide premium collection services for health benefit plans offered through the alliance if the insurer or health maintenance organization offering the plan gives express written authorization to the alliance or any other person or entity acting on behalf of the alliance to act as the insurer's or the health maintenance organization's agent for that purpose;   [PL 1995, c. 673, Pt. A, §3 (NEW).] 3.  Contracts.  Contract with qualified independent 3rd parties for any service necessary to carry out the powers and duties authorized or required by this chapter;   [PL 1995, c. 673, Pt. A, §3 (NEW).] 4.  Standards.  Exclude a carrier or freeze enrollment in a carrier for failure to achieve established quality, access or information reporting standards of the alliance;   [PL 1995, c. 673, Pt. A, §3 (NEW).] 5.  Data collection.  Develop uniform standards for data to be provided by participating carriers and providers. The alliance may collect data necessary for evaluation of the performance of participating carriers and their provider networks by consumers, providers, employers and the superintendent;   [PL 1995, c. 673, Pt. A, §3 (NEW).] 6.  Negotiation.  Negotiate with participating carriers the premium rates charged for coverage offered through the alliance, consistent with rules adopted by the superintendent; or   [PL 1995, c. 673, Pt. A, §3 (NEW).] 7.  Risk adjustment.  Establish procedures, subject to approval by the superintendent, for adjusting payments within each risk pool to participating carriers if the alliance finds that some carriers have a significantly disproportionate share of high-risk or low-risk enrollees.   [PL 1995, c. 673, Pt. A, §3 (NEW).] SECTION HISTORY PL 1995, c. 673, §A3 (NEW). PL 1997, c. 616, §2 (AMD). RR 2001, c. 2, §B43 (COR). RR 2001, c. 2, §B58 (AFF).
24-A ME Rev Stat § 1954 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 18-A: PRIVATE PURCHASING ALLIANCES|24-A §1954. Duties

 §1954. Duties An alliance shall:   [PL 1995, c. 673, Pt. A, §3 (NEW).]1.  Carrier eligibility.  Develop and make available a list of objective criteria, subject to rules adopted by the superintendent, that participating carriers must meet in order to be eligible to participate in the alliance;   [PL 1995, c. 673, Pt. A, §3 (NEW).] 2.  Enrollee choice.  Ensure that enrollees have a choice among a reasonable number of competing carriers and types of health benefit plans.   A.   [PL 2001, c. 369, §2 (RP).]B.   [MRSA T. 24-A §1954, sub-§2, ¶ B (RP).]C.   [PL 1997, c. 370, Pt. A, §2 (RP).][PL 2001, c. 369, §2 (AMD).] 3.  Enrollment.  Develop standard enrollment procedures in accordance with rules adopted by the superintendent;   [PL 1995, c. 673, Pt. A, §3 (NEW).] 4.  Plan descriptions.  Publish educational materials, plan descriptions and comparison sheets describing participating carriers and the health benefit plans available through the alliance for use in enrolling eligible members. The information may include an assessment of utilization management procedures and the level of quality and cost-effective care;   [PL 1995, c. 673, Pt. A, §3 (NEW).] 5.  Enrollee eligibility.  Establish eligibility standards for membership in accordance with rules adopted by the superintendent. Eligibility standards may not relate to health status;   [PL 1995, c. 673, Pt. A, §3 (NEW).] 6.  Acceptance of enrollees.  Accept all applicants for membership that meet the alliance's eligibility standards;   [PL 1995, c. 673, Pt. A, §3 (NEW).] 7.  Risk pools.  Develop standards for classifying groups of participating members into risk pools. The risk pools may include one or more risk pools for enrolled employees and their dependents and a risk pool for enrolled individuals and their dependents;   [PL 1995, c. 673, Pt. A, §3 (NEW).] 8.  Annual report.  Prepare an annual report on the operations of the alliance to the superintendent, which must include an accounting of all outside revenues received by the alliance and internal and independent audits and any other information the superintendent may require;   [PL 1995, c. 673, Pt. A, §3 (NEW).] 9.  Trust account.  Maintain a trust account or accounts for deposit of all money received and collected for the operation of the alliance. An alliance and its board members, employees and agents have a fiduciary duty with respect to all money received or owed to it to ensure payments of its obligations and a full accounting to its members and the superintendent; and   [PL 1995, c. 673, Pt. A, §3 (NEW).] 10.  Violations.  Report to the superintendent any suspected or alleged law violations.   [PL 1995, c. 673, Pt. A, §3 (NEW).] The superintendent may specify further duties by rule.   [PL 1995, c. 673, Pt. A, §3 (NEW).]SECTION HISTORY PL 1995, c. 673, §A3 (NEW). PL 1997, c. 370, §§A1,2 (AMD). PL 2001, c. 369, §2 (AMD).