2023 Maine Revised Statutes › TITLE 24-A: MAINE INSURANCE CODE › Chapter 9: KINDS OF INSURANCE; LIMITS OF RISK; REINSURANCE › Subchapter 1: KINDS OF INSURANCE › 24-A §704. "Health insurance" defined

§704. "Health insurance" defined
1.  Health insurance.
For purposes of this Title, except as provided in subsection 2 and subsection 3, "health insurance" means insurance of human beings against bodily injury, disablement or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness, and every insurance appertaining thereto, including provision for the mental and emotional welfare of human beings by defraying the costs of legal services only to the extent provided for in chapter 38.
[PL 2011, c. 192, §1 (AMD).]
2.  Exceptions.
As used in this Title and Title 24 in any law enacted after the effective date of this subsection that mandates medical benefits or coverage in individual or group health insurance policies under chapter 33 or chapter 35 for certain specific health services or diseases or certain providers of health care services or that mandates rights and obligations under chapter 56‑A, unless the context otherwise indicates, the use of "health insurance" and related terms such as "accident and health insurance," "accident and sickness insurance," "carrier," "health," "health benefit plan," "health care," "health insurer" or "insurer" does not include, unless specifically provided otherwise in the law, the following types of insurance or any combination of those types of insurance: accidental injury, specified disease, hospital indemnity, dental, vision, disability income, long-term care, Medicare supplement or other limited benefit health insurance.
[PL 2001, c. 79, §1 (NEW).]
3.  Health care sharing ministry.
As used in this Title and Title 24, the use of "health insurance" and related terms such as "accident and health insurance," "accident and sickness insurance," "carrier," "health," "health benefit plan," "health care," "health insurer" or "insurer" does not include, unless specifically provided otherwise in the law, a health care sharing ministry, and a health care sharing ministry may not be considered to be engaged in the business of insurance for the purposes of this Title. For the purposes of this section, "health care sharing ministry" means a faith-based, nonprofit organization that is exempt from taxation under the federal Internal Revenue Code and that:
A. Has been in existence continuously since December 31, 1999 and has facilitated the sharing of medical expenses of participants without interruption since December 31, 1999;   [PL 2011, c. 192, §2 (NEW).]
B. Limits participation in the health care sharing ministry to individuals who have a particular religious affiliation;   [PL 2011, c. 192, §2 (NEW).]
C. Acts as a facilitator among participants who have financial and medical needs and matches those participants with other participants with the present ability to assist those with financial and medical needs in accordance with criteria established by the health care sharing ministry;   [PL 2011, c. 192, §2 (NEW).]
D. Provides for the financial and medical needs of a participant through monetary contributions from one participant to another;   [PL 2011, c. 192, §2 (NEW).]
E. Provides amounts that participants may contribute without any assumption of risk or promise to pay among the participants and requires no assumption of risk or promise to pay by the health care sharing ministry to the participants;   [PL 2011, c. 192, §2 (NEW).]
F. Provides a written monthly statement to all participants that lists the total dollar amount of qualified needs submitted to the health care sharing ministry, as well as the amount actually published or assigned to participants for their contribution;   [PL 2011, c. 192, §2 (NEW).]
G. Conducts an annual audit that is performed by an independent certified public accountant in accordance with generally accepted accounting principles and that is made available to the public upon request; and   [PL 2011, c. 192, §2 (NEW).]
H. Provides a written disclaimer on or accompanying all applications and guideline materials distributed by or on behalf of the organization that reads in substance: "Notice: The organization facilitating the sharing of medical expenses is not an insurance company and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills. Participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive payment for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills."   [PL 2011, c. 192, §2 (NEW).]
[PL 2011, c. 192, §2 (NEW).]
SECTION HISTORY
PL 1969, c. 132, §1 (NEW). PL 1983, c. 801, §1 (AMD). PL 2001, c. 79, §1 (RPR). PL 2011, c. 192, §§1, 2 (AMD).