reglab/statecodes huggingface dataset:
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 735 - Term and Universal Life Insurance Reserve Financing › Section 031-735-3 - Exemptions

Current through 2024-29, July 17, 2024
This rule does not apply to:
1. Reinsurance of:
A. Policies that satisfy the criteria for
				exemption set forth in 02-031 CMR §§830(6)(F) or (G); and which are
				issued before the effective date of this rule;
B. Portions of policies that satisfy the
				criteria for exemption set forth in 02-031 CMR §830(6)(E) and which are
				issued before the effective date of this rule;
C. Any universal life policy that meets all
				of the following requirements:
(1) The
				secondary guarantee period, if any, is five years or less;
(2) Specified premium for the secondary
				guarantee period is not less than the net level reserve premium for the
				secondary guarantee period based on the Commissioners Standard Ordinary (CSO)
				valuation tables and valuation interest rate applicable to the issue year of
				the policy; and
(3) The initial
				surrender charge is not less than 100% of the first year annualized specified
				premium for the secondary guarantee period;
D. Credit life insurance;
E. Any variable life insurance policy that
				provides for life insurance, the amount or duration of which varies according
				to the investment experience of any separate account or accounts; nor F. Any
				group life insurance certificate unless the certificate provides for a stated
				or implied schedule of maximum gross premiums required in order to continue
				coverage in force for a period in excess of one year.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 735 - Term and Universal Life Insurance Reserve Financing › Section 031-735-4 - Definitions

Current through 2024-29, July 17, 2024
1. "Actuarial Method" means the methodology
				used to determine the Required Level of Primary Security, as described in
				Section 5.
2. "Covered Policies"
				means policies, other than Grandfathered Policies and policies exempt under
				Section 3, of the following policy types:
A.
				Life insurance policies with guaranteed nonlevel gross premiums and/or
				guaranteed nonlevel benefits, except for flexible premium universal life
				insurance policies; or,
B. Flexible
				premium universal life insurance policies with provisions resulting in the
				ability of a policyholder to keep a policy in force over a secondary guarantee
				period.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 735 - Term and Universal Life Insurance Reserve Financing › Section 031-735-8 - Prohibition against Avoidance

Current through 2024-29, July 17, 2024
No domestic life insurer that has issued or proposed to issue
				  Covered Policies shall take any action or series of actions, or enter into any
				  transaction or arrangement or series of transactions or arrangements, with the
				  purpose of avoiding the requirements of this rule or circumventing the rule's
				  purpose and intent, as set forth in Section 1.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 735 - Term and Universal Life Insurance Reserve Financing › Section 031-735-9 - Effective Date

Current through 2024-29, July 17, 2024
This rule is effective January 1, 2022, and shall apply to
				  all Covered Policies in force on or after that date.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 730 - STANDARDS FOR ACCEPTANCE OF REINSURANCE OF WORKERS' COMPENSATION SELF-INSURANCE › Section 031-730-1 - Purpose and scope

Current through 2024-29, July 17, 2024
The purpose of this Rule is to set standards and procedures
				  for insurers and reinsurers to become eligible to accept reinsurance for
				  self-insured workers' compensation in Maine. This Rule does not apply to
				  reinsurance accounts approved by the Superintendent pursuant to Title
				  39-A
				  M.R.S.A. §403(4-A) and
				  accepting reinsurance only from their member group
				  self-insurers.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 730 - STANDARDS FOR ACCEPTANCE OF REINSURANCE OF WORKERS' COMPENSATION SELF-INSURANCE › Section 031-730-2 - Authority

Current through 2024-29, July 17, 2024
This Rule is adopted pursuant to Title
				  24-A M.R.S.A.
				  §§212,
				  222,
				  410,
				  412,
				  413,
				  421,
				  422,
				  and
				  731-B, and
				  Title
				  39-A
				  M.R.S.A. §403.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 730 - STANDARDS FOR ACCEPTANCE OF REINSURANCE OF WORKERS' COMPENSATION SELF-INSURANCE › Section 031-730-3 - Definitions

Current through 2024-29, July 17, 2024
As used in this Rule, the following terms have the following
				  meanings:
A.
Domestic
				insurer
. A "domestic" insurer is an insurer or reinsurer formed under
				the laws of this State.
B.
Foreign insurer
. A "foreign" insurer is an insurer or reinsurer
				formed under the laws of any state, district, commonwealth, or possession of
				the United States other than the State of Maine. For purposes of this Rule,
				notwithstanding Title
				24-A
				M.R.S.A. §6, "foreign insurer" does not
				include an alien insurer.
C.
Alien insurer
. An "alien" insurer is an insurer, reinsurer, or
				group of insurers or underwriters authorized to assume reinsurance from Maine
				cedents on a group basis, formed under the laws of any country other than the
				United States of America.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 730 - STANDARDS FOR ACCEPTANCE OF REINSURANCE OF WORKERS' COMPENSATION SELF-INSURANCE › Section 031-730-4 - General qualifications

Current through 2024-29, July 17, 2024
A. If the applicant
				is a domestic or foreign insurer, it must be licensed in its domiciliary
				jurisdiction to transact workers' compensation insurance or workers'
				compensation reinsurance.
B.
				Applicants must maintain deposits or trust funds as indicated hereunder.
(1) A domestic insurer or a foreign insurer
				licensed in Maine shall make and maintain deposit funds pursuant to Chapter 15
				of Title 24-A M.R.S.A. as security to Maine resident beneficiary parties to
				reinsurance contracts issued by the company. Such deposit funds must be of a
				market value not less than that required pursuant to Title
				24-A M.R.S.A. §412.
				The Superintendent may require a deposit in excess of the minimum required in
				§ 412 based upon the amount of reinsurance the company has in
				force.
(2) A foreign insurer must
				have on deposit in this state or some other state of the United States where
				licensed, funds that inure to the benefit of Maine resident beneficiary parties
				to reinsurance contracts issued by the company. Such deposited funds must be of
				a market value not less than that required pursuant to Title
				24-A M.R.S.A. §412.
				The Superintendent may require a deposit in excess of the minimum required in
				§ 412 based upon the amount of reinsurance the company has in
				force.
(3) An alien insurer must
				secure its liabilities in a manner approved by the Superintendent, consistent
				with the requirements of Title
				24-A M.R.S.A.
				§731-B and Bureau of Insurance Rule 740.
				The trust instrument, letter of credit, or other governing document must either
				mention the reinsured employer(s) by name or expressly specify that the
				beneficiaries include all reinsured employers and groups with workers'
				compensation self-insurance risk in Maine.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 730 - STANDARDS FOR ACCEPTANCE OF REINSURANCE OF WORKERS' COMPENSATION SELF-INSURANCE › Section 031-730-6 - Application

Current through 2024-29, July 17, 2024
Every applicant must make an initial filing to the
				  Superintendent of Insurance, which shall include:
A. A written application, on forms to be
				supplied by the Superintendent, signed under oath by the chief executive
				officer of the company. Applicants are exempt from providing information
				hereunder to the extent that such information has been provided as part of a
				filing to obtain or maintain a certificate of authority in the State of Maine.
				The application shall contain among other things:
(1) The name and home office address of the
				applicant.
(2) The location of its
				principal office in the United States.
(3) The names of officers principal to the
				conduct of the applicant's business.
(4) Whether a stock, mutual, or other type of
				risk organization.
(5) Such other
				information as may be considered necessary and appropriate by the
				Superintendent.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 730 - STANDARDS FOR ACCEPTANCE OF REINSURANCE OF WORKERS' COMPENSATION SELF-INSURANCE › Section 031-730-7 - Approval of forms

Current through 2024-29, July 17, 2024
A. Each contract of
				workers' compensation reinsurance that is proposed for use in this state must
				be filed for approval at least 30 days in advance of the intended
				implementation date. A self-addressed stamped envelope must be included with
				the submission for use in return correspondence. Insofar as is practicable, a
				contract so approved may be modified with less than 30 days' advance filing
				notice if the Superintendent determines the modifications suggested are not
				contrary to the provisions of Title
				39-A
				M.R.S.A. §403, or Bureau of Insurance
				Rules, and are necessary to effect required reinsurance coverage to authorize
				the self-insurer to operate a plan of workers' compensation
				self-insurance.
B. The text of any
				forms must be printed in at least ten-point type, contain not more than sixteen
				characters per inch, and must meet the minimum requirements for reading ease as
				set forth in Title
				24-A M.R.S.A.
				§2441.
C. The filing of forms for approval must be
				accompanied by the appropriate fee as indicated in Title
				24-A M.R.S.A.
				§601.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 730 - STANDARDS FOR ACCEPTANCE OF REINSURANCE OF WORKERS' COMPENSATION SELF-INSURANCE › Section 031-730-8 - Annual filings and report of changes

Current through 2024-29, July 17, 2024
A. If the
				applicant is a United States corporation, on or before April 15 of each year
				succeeding the initial filing, or if the applicant is an alien insurer, within
				75 days subsequent to the close of its elected fiscal year but not later than
				September 30 in any calendar year, the applicant must file with the
				Superintendent:
(1) A certified copy of the
				annual statement for the year immediately preceding.
(2) An audited financial statement for the
				year immediately preceding.
(3) A
				copy of the last report of examination by the supervisory official in the
				applicant's state or country of domicile.
(4) Any change in the listing of reinsurers
				to whom the applicant retrocedes risks.
(5) Any pertinent prospectus, tender offer
				materials, or details of any mergers, reorganizations or consolidations for the
				most recent year.
(6) Any change in
				the organizational chart of the holding company system.
(7) Any change in majority ownership of the
				applicant, or any change in ownership of any shareholder(s) who own 5 percent
				or more of the outstanding shares of the applicant. If the applicant is a
				wholly owned subsidiary, this requirement shall apply to the parent
				company.
(8) The most recent Form
				10-K (and Forms 10-Q since the date of the 10-K) and proxy statement, if the
				applicant is registered with the Securities and Exchange Commission.
(9) Any changes in any management agreements
				by which effective power to manage or influence over this class or any other
				major class of the applicant's business is transferred to others, including
				copies of any new agreements entered into during the most recent
				year.
(10) Biographical information
				for any new officers and directors appointed or elected during the most recent
				year. The form prescribed by the National Association of Insurance
				Commissioners may be substituted for the Maine form. NOTE: Any such data
				submitted as part of a holding company registration shall be held as
				confidential information pursuant to Title
				24-A
				M.R.S.A.
				§222(13-A).
(11) An acknowledged statement signed by the
				chief executive officer of the applicant attesting that the applicant's license
				is not under suspension or revocation in any jurisdiction except as may therein
				be disclosed. If such an action has been taken or is being taken, or if a
				license has been refused, an explanation should be provided along with a copy
				of any order or finding.
(12) Such
				other information as the Superintendent may consider necessary.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 730 - STANDARDS FOR ACCEPTANCE OF REINSURANCE OF WORKERS' COMPENSATION SELF-INSURANCE › Section 031-730-9 - Approval or disapproval of eligibility

Current through 2024-29, July 17, 2024
The Superintendent shall, within 45 days upon receipt of a
				  complete application, review and approve or disapprove the applicant as a
				  reinsurer for self-insurer workers' compensation on risks resident to the State
				  of Maine. If at any time the applicant no longer meets the eligibility
				  requirements of this Rule or violates any provision of Title 24-A M.R.S.A., the
				  Superintendent may terminate the applicant's authority to accept reinsurance
				  for self-insured workers' compensation in Maine. The disapproval of
				  applications or termination of authority shall be governed by the procedures
				  established in the
Maine Administrative Procedure Act
, Title 5
				  M.R.S.A., Chapter 375, and in Title 24-A M.R.S.A., Chapter 3 to the extent
				  applicable.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 730 - STANDARDS FOR ACCEPTANCE OF REINSURANCE OF WORKERS' COMPENSATION SELF-INSURANCE › Section 031-730-10 - Severability

Current through 2024-29, July 17, 2024
If any provision of this Rule is held invalid, the remainder
				  shall not be affected.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 730 - STANDARDS FOR ACCEPTANCE OF REINSURANCE OF WORKERS' COMPENSATION SELF-INSURANCE › Section 031-730-11 - Effective date

Current through 2024-29, July 17, 2024
This Rule is effective September 20, 1993. The 2015
				  Amendments to this Rule are effective December 9, 2015.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-1 - Authority

Current through 2024-29, July 17, 2024
This rule is promulgated pursuant to Title
				  24-A M.R.S.A.
				  §§212 and
				  731-B(7).
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-2 - Purpose

Current through 2024-29, July 17, 2024
The purpose of this rule is to set forth procedural
				  requirements to carry out the provisions of the law on credit for reinsurance
				  as set forth in Title
				  24-A M.R.S.A.
				  §731-B, for the protection of ceding
				  insurers in this State and their policyholders.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-3 - Severability

Current through 2024-29, July 17, 2024
If any provision of this rule or its application to any
				  person or circumstance is held invalid, such determination shall not affect
				  other provisions or applications of this rule which can be given effect without
				  the invalid provision or application.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-4 - Definitions

Current through 2024-29, July 17, 2024
As used in this rule the following terms have the following
				  meanings:
A.
"Jurisdiction"
means any state, district, or territory of the United
				States, any lawful national government, and any supranational body or
				subdivision or dependency of a national government that is internationally
				recognized as exercising regulatory authority over the business of
				insurance.
B.
"Substantially similar"
standard means credit for reinsurance
				standards which the Superintendent determines equal or exceed the standards of
				Title
				24-A M.R.S.A.
				§731-B and this rule in all material
				respects.
C.
"Beneficiary"
means the entity for whose benefit a trust has been
				established and includes any successor by operation of law of the beneficiary,
				including without limitation any liquidator, rehabilitator, receiver, or
				conservator.
D.
"Grantor"
means the entity that has established a trust for the
				benefit of the beneficiary. For a trust established pursuant to a reinsurance
				agreement, the grantor is generally the assuming insurer.
E.
"Obligations"
under a
				reinsurance agreement means:
(1) For business
				ceded by property and casualty insurers:
(a)
				Reinsured losses, allocated loss expenses, and unallocated loss expenses if a
				part of the reinsurance agreement, paid by the ceding company but yet to be
				recovered from the assuming insurer;
(b) Reserves for reinsured losses reported
				and outstanding;
(c) Reserves for
				reinsured losses incurred but not reported;
(d) Reserves for allocated reinsured loss
				expenses, and, if unallocated loss expenses are covered by the agreement,
				reserves for unallocated reinsured loss expenses; and
(e) Reserves for unearned premiums.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-5 - Reinsurers licensed in this State

Current through 2024-29, July 17, 2024
Pursuant to Title
				  24-A M.R.S.A.
				  §731-B(1)(A), the
				  Superintendent shall allow credit for reinsurance ceded by a domestic insurer
				  to an assuming insurer which has been licensed in this State at all times for
				  which credit for reinsurance under this section is claimed on the ceding
				  insurer's statutory financial statement filed pursuant to Title
				  24-A M.R.S.A.
				  §423 or
				  423-A.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-7 - Required filings by reinsurers not licensed or certified in this State

Current through 2024-29, July 17, 2024
In order for credit to be granted under Sections
				  8,
				  9, or
				  11 for reinsurance ceded to an
				  unlicensed reinsurer, the reinsurer must file a properly executed Form AR-1, as
				  shown in the appendix to this rule, as evidence of its submission to this
				  State's jurisdiction and to this State's authority to examine its books and
				  records at the reinsurer's expense. Upon request of the Superintendent, the
				  reinsurer shall provide any information requested by the Superintendent that is
				  relevant to its financial condition or otherwise relevant to determining its
				  continuing qualification under the relevant provisions of this rule. Annual
				  regulatory statements and annual audited financial statements filed with the
				  NAIC and made available to the Superintendent by the NAIC are deemed to be
				  filed with the Superintendent, and no additional filings are required unless
				  otherwise ordered by the Superintendent.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-8 - Accredited reinsurers

Current through 2024-29, July 17, 2024
Pursuant to Title 24 A M.R.S.A. §731- B(1)(B-1), the
				  Superintendent shall allow credit for reinsurance ceded by a domestic insurer
				  to an assuming insurer which has been accredited as a reinsurer in this State
				  at all times for which statutory financial statement credit is claimed under
				  this section. If the Superintendent determines that an accredited reinsurer has
				  failed to meet or maintain any of the qualifications for accreditation, the
				  Superintendent may suspend or revoke the reinsurer's accreditation after
				  written notice and opportunity for hearing. Credit for reinsurance shall not be
				  allowed under this section if the assuming insurer's accreditation has been
				  revoked by the Superintendent or if the reinsurance was ceded while the
				  assuming insurer's accreditation was under suspension by the
				  Superintendent.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-9 - Reinsurers domiciled and licensed in other states

Current through 2024-29, July 17, 2024
Pursuant to Title 24 A M.R.S.A. §731- B(1)(B), the
				  Superintendent shall allow credit for reinsurance ceded by a domestic insurer
				  to an assuming insurer which has been domiciled and licensed in another State
				  that employs standards regarding credit for reinsurance substantially similar
				  to those applicable in Section 731-B at all times for which statutory financial
				  statement credit for reinsurance is claimed under this section, has filed
				  evidence of its submission to this State's authority to examine its books and
				  records, has appointed an agent to receive service of legal process pursuant to
				  Title
				  24-A M.R.S.A.
				  §421, has submitted to the authority of
				  any court of competent jurisdiction in the State of Maine or any other state in
				  the United States for the adjudication of any issues arising out of the
				  reinsurance agreement(s), and maintains a surplus as regards policyholders in
				  an amount not less than $20,000,000. An insurer with a qualifying United States
				  port of entry, as determined by the Superintendent pursuant to Title
				  24-A M.R.S.A.
				  §413-A(1), is
				  considered domiciled in that State. The minimum surplus requirement does not
				  apply to reinsurance ceded and assumed pursuant to pooling arrangements
				  approved by the Superintendent among insurers in the same holding company
				  system.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-12 - Required conditions of single-beneficiary trust agreements

Current through 2024-29, July 17, 2024
Pursuant to Title
				  24-A M.R.S.A.
				  §731-B(1)(D), the
				  Superintendent shall allow credit for reinsurance ceded by a domestic insurer
				  to an assuming insurer, under reinsurance contracts that comply with Sections
				  14 and
				  15, if at all times for which
				  statutory financial statement credit is claimed under this section, a trust
				  fund is maintained for the sole benefit of the ceding insurer, including any
				  successor by operation of law, in compliance with this section and other
				  applicable provisions of this rule. The credit allowed shall be limited to the
				  lesser of the current fair market value of the trust assets or the amount of
				  the reinsurance obligations secured by the trust.
A. No amendment to the trust shall be
				effective unless reviewed and approved in advance by the
				Superintendent.
B. The trust
				agreement shall be entered into between the beneficiary, the grantor, and a
				trustee which shall be a qualified United States financial institution as
				defined in Title
				24-A M.R.S.A.
				§731-B(4-A).
C. All assets in the trust account credited
				thereunder shall be held by the trustee in the United States.
D. The trust agreement must provide that:
(1) The beneficiary shall have the right to
				withdraw assets from the trust account at any time, without notice to the
				grantor, subject only to written notice from the beneficiary to the
				trustee;
(2) No other statement or
				document is required to be presented in order to withdraw assets, except that
				the beneficiary may be required to acknowledge receipt of withdrawn
				assets;
(3) No other conditions or
				qualifications not contained in the trust agreement shall apply; and
(4) The agreement constitutes the entire
				agreement of the parties and no other documents will be referred to or apply,
				except as expressly provided in the agreement. Any such express exceptions must
				be consistent with Section
				13 of this rule.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-13 - Permitted conditions of trust agreements

Current through 2024-29, July 17, 2024
When a trust agreement is established in conjunction with a
				  reinsurance agreement, the trust agreement may contain the following
				  provisions:
A. Notwithstanding other
				provisions of this rule, where it is customary to provide a trust agreement for
				a specific purpose, a provision that the ceding insurer, if it is not itself
				the subject of a delinquency proceeding, may undertake to use and apply amounts
				drawn upon the trust account, without diminution because of the insolvency of
				the ceding insurer or the assuming insurer, only for the following purposes:
(1) To pay or reimburse the ceding insurer
				for the assuming insurer's share under the reinsurance agreement of:
(a) For life, annuity, and health risks,
				surrenders and benefits or losses paid by the ceding insurer under the terms
				and provisions of the policies reinsured under the reinsurance agreement, but
				not yet recovered from the assuming insurer, and premiums returned to
				policyowners on account of cancellations of policies reinsured under the
				reinsurance agreement, but not yet recovered from the assuming insurer;
				and
(b) For other risks, any losses
				and allocated loss expenses, or unallocated loss expenses if contained within
				the agreement, paid by the ceding insurer but not recovered from the assuming
				insurer, or unearned premiums due to the ceding insurer if not otherwise paid
				by the assuming insurer;
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-14 - Reinsurance contracts - mandatory provisions

Current through 2024-29, July 17, 2024
Except for reinsurance required by law, the Superintendent
				  may not grant credit for reinsurance unless the reinsurance agreement contains
				  the provisions specified in this section. In determining whether to grant full
				  credit under Title
				  24-A M.R.S.A.
				  §731-B(1)(D) for
				  reinsurance required by law, the Superintendent shall consider whether the
				  reinsurance program provides protections comparable to those specified in this
				  section, if applicable to the nature of the reinsurance program.
A. An insolvency clause meeting the
				requirements of Title
				24-A M.R.S.A.
				§731-B(5), providing
				that in the event of the insolvency of the ceding insurer, the reinsurance is
				payable under a contract or contracts reinsured by the assuming insurer on the
				basis of reported claims allowed by the court, without diminution because of
				the insolvency of the ceding insurer. The payments must be made directly to the
				ceding insurer or to the ceding insurer's domiciliary receiver unless the
				contract or other written agreement specifically provides another payee in the
				event of the insolvency of the ceding insurer or unless the assuming insurer,
				with the consent of the direct insured or insureds, has assumed the policy
				obligations of the ceding insurer as direct obligations of the assuming insurer
				to the payees under the reinsured policies and in substitution for the
				obligations of the ceding insurer to those payees.
B. A provision, meeting the requirements of
				Title
				24-A M.R.S.A.
				§731-B(2)(A), requiring
				the assuming insurer, at the request of the ceding insurer, to submit to the
				jurisdiction of any court of competent jurisdiction in any state of the United
				States, or to an alternative dispute resolution panel if provided in the
				agreement, to comply with all requirements necessary to give the court or panel
				jurisdiction, and to abide by the final decision after appeal rights have been
				exhausted.
C. A provision, meeting
				the requirements of Title
				24-A M.R.S.A.
				§731-B(2)(B),
				designating the Superintendent or an attorney as the assuming insurer's
				attorney upon whom may be served any lawful process in any action, suit, or
				proceeding instituted by or on behalf of the ceding company.
D. An intermediary clause, if payments may be
				made through intermediaries, under which the intermediary's credit risk is
				borne by the assuming insurer.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-16 - Reinsurers utilizing letters of credit

Current through 2024-29, July 17, 2024
A. A letter
				of credit may be used to reduce a ceding insurer's liability in its financial
				statements for reinsurance ceded to an unauthorized assuming insurer, pursuant
				to Title 24 A M.R.S.A. §731- B(1)(D), if the reinsurance contract complies
				with Sections
				14 and
				15, and the letter of credit
				qualifies under this section, names the ceding insurer as beneficiary, and has
				been in force at all times for which statutory financial statement credit is
				claimed under this section. The reduction in liabilities of the ceding insurer
				is limited to the lesser of the value of the specific obligations under the
				reinsurance agreement or the amount available under the letter of
				credit.
B. A letter of credit must
				be clean, irrevocable, and unconditional and issued or confirmed by a qualified
				United States financial institution as defined in Title
				24-A M.R.S.A.
				§731-B(4). The letter
				of credit shall specify an issue date and date of expiration and shall
				stipulate that the beneficiary need only draw a sight draft under the letter of
				credit and present it to obtain funds and that no other document need be
				presented. The letter of credit shall also state that it is not subject to any
				condition or qualifications not contained therein. In addition, the letter of
				credit itself shall not contain reference to any other agreements, documents,
				or entities, except as provided in Subsection F.
C. The heading of the letter of credit may
				include a boxed section containing the name of the applicant and other
				appropriate notations to provide a reference for the letter of credit. The
				boxed section shall be clearly marked to indicate that such information is for
				internal identification purposes only.
D. A letter of credit shall contain a
				statement to the effect that the obligation of the qualified United States
				financial institution which issues a letter of credit is in no way contingent
				upon reimbursement with respect thereto.
E. The term of a letter of credit shall be
				for at least one year and shall contain an "evergreen clause" which prevents
				the expiration of the letter of credit without due notice from the issuer. The
				"evergreen clause" shall provide for a period of no less than thirty (30) days'
				notice prior to expiration date or at nonrenewal.
F. A letter of credit shall state that it is
				subject to and governed by one of the following:
(1) The laws of this State;
(2) The Uniform Customs and Practice for
				Documentary Credits of the International Chamber of Commerce Publication 600
				(UCP 600), or any successor publication; or
(3) International Standby Practices of the
				International Chamber of Commerce Publication 590 (ISP98), or any successor
				publication.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-17 - Other security

Current through 2024-29, July 17, 2024
A ceding insurer may take credit under Title 24 A M.R.S.A.
				  §731- B(1)(D) for reinsurance ceded in accordance with Sections
				  14 and
				  15, in an amount not to exceed the
				  amount recognized by the ceding insurer as a liability for the risks ceded
				  under the reinsurance agreement, to the extent that the assuming insurer's
				  obligations have been secured at all times for which statutory financial
				  statement credit is claimed under this section by unencumbered admitted assets,
				  of a character, maturity, and value to fulfill the intent of the agreement,
				  withheld by the ceding insurer in the United States, subject to withdrawal
				  solely by the ceding insurer and under its exclusive control. The assets must
				  be of the following form:
A.
				Cash;
B. Securities listed by the
				Securities Valuation Office of the NAIC, including those deemed exempt from
				filing as defined by the Purposes and Procedures Manual of the Securities
				Valuation Office, and qualifying as admitted assets;
C. Letter of credit in compliance with
				Section
				16;
D. Any other form of security that the
				Superintendent finds to be acceptable consistent with the purposes of this
				rule.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Section 031-740-18 - Effective date

Current through 2024-29, July 17, 2024
This rule is effective October 1, 1993. The 2016 amendments
				  to this rule are effective January 24, 2016. The 2022 amendments to this rule
				  are effective March 1, 2022. All new and renewal reinsurance transactions
				  executed on or after the effective date of this rule shall conform to the
				  requirements of Title 24-A M.R.S.A. and this rule, as in force on the date of
				  the transaction, if credit is to be given to the ceding insurer for such
				  reinsurance.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Form 031-740-AR-1 - CERTIFICATE OF ASSUMING INSURER

Current through 2024-29, July 17, 2024
I, _______________________, ___________________ of
				  ___________________________,
(name of officer) (title of officer) (name of assuming
				  insurer)
the assuming insurer under a reinsurance agreement(s) with
				  one or more insurers domiciled in the State of Maine, hereby certify that
				  __________________________ ("Assuming Insurer"):
(name of assuming insurer)
1. Submits to the jurisdiction of any court
				of competent jurisdiction in the State of Maine for the adjudication of any
				issues arising out of the reinsurance agreement(s), agrees to comply with all
				requirements necessary to give such court jurisdiction, and will abide by the
				final decision of such court or any appellate court in the event of an appeal.
				Nothing in this paragraph constitutes or should be understood to constitute a
				waiver of Assuming Insurer's rights to commence an action in any court of
				competent jurisdiction in the United States, to remove an action to a United
				States District Court, or to seek a transfer of a case to another court as
				permitted by the laws of the United States or of any state in the United
				States. This paragraph is not intended to conflict with or override the
				obligation of the parties to the reinsurance agreement(s) to arbitrate their
				disputes if such an obligation is created in the agreement(s).
2. Designates the Superintendent of Insurance
				of the State of Maine as its lawful attorney upon whom may be served any lawful
				process in any action, suit or proceeding arising out of the reinsurance
				agreements(s) instituted by or on behalf of the ceding insurer.
3. Submits to the authority of the
				Superintendent of Insurance to examine its books and records and agrees to bear
				the expense of any such examination.
4. Submits with this form a current list of
				insurers domiciled in the State of Maine reinsured by Assuming Insurer and
				undertakes to submit additions to or deletions from the list to the
				Superintendent at least once per calendar quarter.
Dated: ______________
				  ___________________________________
(name of assuming insurer)
BY: ___________________________________
(name of officer)
___________________________________
(title of officer)
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 740 - CREDIT FOR REINSURANCE › Form 031-740-CR-F - REPORT OF ASSUMED AND CEDED PROPERTY/CASUALTY REINSURANCE

Current through 2024-29, July 17, 2024
Form CR-F - PART 1
Assumed Reinsurance as of December 31, Current Year (000
				  Omitted)
1
2
3
4
5
Reinsurance On
9
10
11
12
13
14
15
Company Code or ID Number
Name of Reinsured
Domiciliary Jurisdiction
Assumed Premium
6 Paid Losses and Loss Adjustment Expenses
7 Known Case Losses and LAE
8 Cols. 6 + 7
Contingent Commissions Payable
Assumed Premiums Receivable
Unearned Premium
Funds Held By or Deposited With Reinsured
							 Companies
Letters of Credit Posted
Amount of Assets Pledged or Compensating Balances to
							 Secure Letters of Credit
Amount of Assets Pledged or Collateral Held in
							 Trust
Totals
Form CR-F - PART 2
Ceded Reinsurance as of December 31, Current Year (000
				  Omitted)
1
2
3
4
5
6
Reinsurance Recoverable On
Reinsurance Payable
18
19
Company Code or ID Number
Name of Reinsurer
Domiciliary Jurisdiction
Reinsurance Contracts Ceding 75% or More of Direct
							 Premiums Written
Reinsurance Premiums Ceded
7 Paid Losses
8 Paid LAE
9 Known Case Loss Reserves
10 Known Case LAE Reserves
11 IBNR Loss Reserves
12 IBNR LAE Reserves
13 Unearned Premiums
14 Contingent Commissions
15 Cols. 7 through 14 Totals
16 Ceded Balances Payable
17 Other Amounts Due to Reinsurers
Net Amount Recoverable From Reinsurers Cols. 15 - [16
							 + 17]
Funds Held by Company Under Reinsurance
							 Treaties
Totals
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 745 - INDIVIDUAL HEALTH INSURANCE PILOT PROJECTS FOR PERSONS UNDER 30 YEARS OF AGE › Section 031-745-1 - AUTHORITY

Current through 2024-29, July 17, 2024
This Rule is adopted by the Superintendent pursuant to
				   24-A M.R.S.A.
				  §§212 and
				  2736-C.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 745 - INDIVIDUAL HEALTH INSURANCE PILOT PROJECTS FOR PERSONS UNDER 30 YEARS OF AGE › Section 031-745-2 - PURPOSE

Current through 2024-29, July 17, 2024
The purpose of this Rule is to establish procedures and
				  policies pursuant to
				   24-A M.R.S.A.
				  §2736-C(10) for
				  submitting a pilot project proposal to provide health insurance coverage to
				  persons under 30 years of age, to establish minimum requirements for approval
				  of a pilot project, and to establish requirements for minimum
				  benefits.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 745 - INDIVIDUAL HEALTH INSURANCE PILOT PROJECTS FOR PERSONS UNDER 30 YEARS OF AGE › Section 031-745-3 - APPLICABILITY AND SCOPE

Current through 2024-29, July 17, 2024
This Rule applies to any health insurance carrier that offers
				  individual expense incurred health insurance plans in the State of Maine, is
				  marketing an individual insurance plan subject to
				   24-A M.R.S.A.
				  §2736-C in this State, and has a
				  medical-loss ratio of at least 70% in the individual market. Those carriers may
				  issue pilot project plans only to individuals under age 30.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 745 - INDIVIDUAL HEALTH INSURANCE PILOT PROJECTS FOR PERSONS UNDER 30 YEARS OF AGE › Section 031-745-4 - DEFINITIONS

Current through 2024-29, July 17, 2024
For purposes of this Rule, the following terms have the
				  following meaning:
1. "Deductible"
				means the dollar amount the insured must pay directly to the provider for
				covered services in a plan year before any benefits subject to the deductible
				are payable by the plan.
2.
				"Coinsurance" means the percentage of eligible charges that the insured must
				pay directly to the provider, after any deductible applicable to the service
				has been satisfied.
3. "Copayment"
				means a flat dollar charge that must be paid by the insured directly to the
				provider for each service or prescription.
4. "Out-of-Pocket Expense" means an eligible
				charge paid by the insured directly to a provider for covered services,
				including deductibles, coinsurance and copayments.
5. "Eligible Charge" means:
A. An amount the provider is required to
				accept as payment in full for a given service under the terms of its contract
				with an HMO, non-profit service organization, preferred provider organization,
				or plan sponsor.
B. If a service is
				not rendered pursuant to a contract with an insurance carrier, HMO, non-profit
				service organization, preferred provider organization or plan sponsor, the
				eligible charge is the lesser of:
(1) The
				actual amount charged; or
(2) The
				Usual and Customary Charge for the services provided, taking into consideration
				the geographic area in which the services are provided and significant regional
				variations in the cost of services. A relative value scale or other reasonable
				methodology may be used in calculating the usual and customary
				charge.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 745 - INDIVIDUAL HEALTH INSURANCE PILOT PROJECTS FOR PERSONS UNDER 30 YEARS OF AGE › Section 031-745-5 - PROCESS FOR SUBMITTING A PILOT PROJECT PROPOSAL

Current through 2024-29, July 17, 2024
An applicant for a pilot project proposal pursuant to
				   24-A M.R.S.A.
				  §2736-C(10) must file
				  with the Superintendent an application accompanied by an application fee of $20
				  and provide the following information:
1. A copy of the proposed plan of
				insurance;
2. A detailed
				description of all provider networks;
3. A rate filing for the plan;
4. An explanation of how the plan will be
				marketed;
5. The text of the
				notification to be provided enrollees pursuant to Section
				6 of this Rule explaining the
				mandatory increase in plan benefits at age 30 and their guaranteed issue rights
				to purchase other individual health insurance plans without being subject to a
				pre-existing condition exclusion; and
6. A completed Bureau of Insurance pilot
				project review standards checklist.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 745 - INDIVIDUAL HEALTH INSURANCE PILOT PROJECTS FOR PERSONS UNDER 30 YEARS OF AGE › Section 031-745-6 - GUARANTEED ISSUE AND MANDATORY BENEFIT INCREASES

Current through 2024-29, July 17, 2024
1.
				The guaranteed issue requirements of
				 24-A M.R.S.A.
				§2736-C apply to plans approved pursuant
				to this Rule only with respect to Maine residents who apply for coverage prior
				to the age of 30.
2. All plans
				issued pursuant to this Rule must provide for a mandatory increase in benefits
				effective at the first annual renewal after the enrollee reaches the age of 30.
A. Benefits under the plan for persons 30 and
				over must be the same as benefits under one of the carrier's standardized
				health insurance plans (Standardized Plan A or Standardized Plan(B).
B. Upon providing the enrollee with at least
				60 days notice, the carrier may increase premiums to the same level as would
				apply to a new enrollee for one of the carrier's standardized plans.
C. The notice of rate increase must advise
				the enrollee of all of the carrier's other individual health insurance plans
				available in the State of Maine on a guaranteed issue basis pursuant to
				 24-A M.R.S.A.
				§2736-C.
D. A carrier's rate revisions for the
				standardized plans must reflect the combined claims experience of those who
				purchased the standardized plans directly and those who receive standardized
				plan benefits pursuant to this subsection.
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 745 - INDIVIDUAL HEALTH INSURANCE PILOT PROJECTS FOR PERSONS UNDER 30 YEARS OF AGE › Section 031-745-7 - MINIMUM PLAN REQUIREMENTS FOR PERSONS UNDER 30 YEARS OF AGE

Current through 2024-29, July 17, 2024
1. A plan issued pursuant to this Rule must
				provide coverage for medically necessary hospital, medical, and surgical
				expenses, subject to the minimum benefit requirements set forth in this
				section. Carriers may offer pilot project plans with greater benefits.
A. The first three office visits must be
				covered prior to the application of any plan deductible.
(1) The first three office visits may be
				subject to cost sharing not greater than a $25 copayment or 20% of eligible
				charges for a participating provider. Additional services other than charges
				for the office visit may be subject to the plan deductible or to higher cost
				sharing, even if performed during one of the first three office
				visits.
(2) Enrollees may use the
				first three office visits for medically necessary services including, but not
				limited to, the following types of services.
(a) Routine care
(b) Preventive care
(c) Sick visits
(d) Eye examinations
(e) Family planning
(f) Consultations with a specialist
(g) Physical, speech, and occupational
				therapies
(h) Care by a
				chiropractor
(i) Outpatient mental
				health services
(j) Outpatient drug
				rehabilitation services
(k)
				Outpatient alcohol rehabilitation services
Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 745 - INDIVIDUAL HEALTH INSURANCE PILOT PROJECTS FOR PERSONS UNDER 30 YEARS OF AGE › Section 031-745-8 - LOSS RATIO REQUIREMENTS

Current through 2024-29, July 17, 2024
To be eligible to market plans to persons under 30 years of
				  age pursuant to this Rule, a carrier must offer Standardized Plan A and
				  Standardized Plan B and have a medical loss ratio of at least 70% in the
				  individual market. The loss ratio is determined by dividing individual incurred
				  claims by individual earned premiums based on recent Rule 940 reports. The
				  number of Rule 940 reports to be used will be based on the number of member
				  months for the individual line on the carrier's Rule 945 reports reduced by any
				  member months associated with short-term policies as defined by
				   24-A M.R.S.A.
				  §2849-B.
1. The most recent Rule 940 report must be
				used if the number of member months for that year is at least 12,000.
2. The sum of incurred claims and the sum of
				earned premiums from the two most recent Rule 940 reports must be used if (1)
				does not apply and the number of member months for those two years is at least
				12,000.
3. The sum of incurred
				claims and the sum of earned premiums from the three most recent Rule 940
				reports must be used if (1) and (2) do not apply and the number of member
				months for those three years is at least 12,000.
4. The sum of incurred claims and the sum of
				earned premiums from the four most recent Rule 940 reports must be used if (1)
				, (2) , and (3) do not apply.