Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 857 - Small Business Health Insurance Premium Support Program › Section 031-857-4 - Premium Relief Credit Amounts and Requirement that Credits be Shared with Employees

Current through 2024-29, July 17, 2024
1. Throughout the
				duration of the program, small group health insurance carriers shall provide
				premium relief credits to eligible small businesses based on the number of
				enrolled eligible employees and covered beneficiaries. The program shall
				reimburse small group health insurance carriers for those premium relief
				credits and for their reasonable expenses in administering the program.
2. Premium relief credits shall be
				based upon the following four subscriber types: Employee Only; Employee and
				Spouse or Partner; Employee with One or More Children; and Employee and Spouse
				or Partner with One or More Children. "Children" includes adult children
				covered by the employee's plan. Premium relief payments will be provided based
				upon subscriber type and will not vary based upon the number of children
				included in a subscriber's enrollment. Small group health insurance carriers
				are permitted to use different terminology for these four subscriber types so
				long as the terminology corresponds to the family compositions specified by
				this rule. If more than one member of the same household is employed by the
				same employer, credits shall be allocated in a manner consistent with the
				premium billing and employee contributions.
3. The amounts of the premium relief credits
				may be adjusted by the Superintendent throughout the duration of the program
				based upon available funding. Changes to the credit amounts, if any, will be
				communicated through a bulletin.
4.
				The initial monthly credit amounts are $50 per employee, $50 per covered spouse
				or domestic partner, and an additional $30 for any subscriber type that
				includes child coverage, based upon the following subscriber types:
Employee: $50
Employee and Spouse or Partner: $100
Employee + Child(ren): $80
Employee and Spouse or Partner + Child(ren): $130
5. Monthly premium relief credits
				may not be prorated by the carrier. The full monthly credit specified by this
				subsection shall be provided if an employee or beneficiary was enrolled in the
				plan during all or any part of the month, but not to exceed the total premium
				charged for that employee and any beneficiaries.
6. Eligible small businesses are required to
				divide the premium relief credits each month with each enrolled eligible
				employee in at least the same proportion as the premium contributions by the
				employer and employee.
A. This subsection
				does not prohibit an employer from passing through the full amount of the
				premium relief credit to its employees, or some other amount that is higher
				than the minimum required by this subsection.
B. If employee contributions are paid through
				weekly or biweekly payroll deductions, or some other basis that does not
				coincide with a calendar month, the employee's share of the credit may be
				prorated accordingly so long as the employee receives the full amount of the
				credit due for each month.