Title 24-A

A person, including a member insurer or an agent or affiliate of a member insurer, may not make, publish, disseminate, circulate or place before the public or cause directly or indirectly to be made, published, disseminated, circulated or placed before the public in any newspaper…

1. Credit allowed. A member insurer may offset against its premium tax liability to this State an assessment described in section 4609, subsection 2‑A, paragraph B and for which a certificate under section 4609, subsection 9 is issued, to the extent of 20% of the amount of the as…

1. Default. No contract of life, noncancellable health, hospital expense or hospital and surgical expense, insurance which goes into effect in this State on or after the 30th day after January 2, 1970 shall lapse during any 30-day period immediately following the inception of a s…

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1981, c. 234, §4 (NEW).] 1. Applicant. "Applicant" means: A. In the case of an individual Medicare supplement policy, the person who seeks to contract for insuran…

1. Application. Except as otherwise specifically provided in section 5013, this chapter applies to: A. All Medicare supplement policies delivered or issued for delivery in this State on or after the effective date of this section; and [PL 1991, c. 740, §2 (NEW).] B. All certifica…

1. Duplicate benefits. A Medicare supplement policy or certificate in force in the State may not contain benefits that duplicate benefits provided by Medicare. 2. Standardization. The superintendent may adopt rules specifying the minimum Medicare supplement contract benefits requ…

1. Persons provided continuity of coverage. This section provides continuity of coverage for a person who has a Medicare supplement policy and seeks coverage under a new Medicare supplement policy with the same or lesser benefits if: A. That person, including a person entitled to…

1. Any Medicare supplement policy or contract is subject to the minimum loss ratio standards of section 2413, subsection 1, paragraph F, as well as any other laws of this State as apply to rate filings with respect to health insurance and nonprofit hospital and medical service or…

1. Delivery of outline of coverage. In order to provide for full and fair disclosure in the sale of Medicare supplement policies, no Medicare supplement policy or certificate may be delivered in this State, unless an outline of coverage is delivered to the applicant at the time a…

Every issuer of Medicare supplement insurance policies or certificates in this State shall provide a copy of any Medicare supplement advertisement intended for use in this State, whether through written, radio or television medium, to the superintendent for review or approval by …

Medicare supplement policies and certificates must have a notice prominently printed on the first page of the policy or certificate or attached to the policy or certificate, stating in substance that the applicant has the right to return the policy or certificate within 30 days o…

1. Applicability. This section applies to individual policies and group certificates and policies issued in Maine or covering Maine residents. 2. Insured's right to replace coverage. Insureds under Medicare supplement policies issued prior to January 1, 1992 shall be permitted at…

An issuer offering coverage under a Medicare supplement policy in this State shall offer coverage under its standardized plans to all individuals, regardless of age, who are entitled to Medicare benefits due to disability. An issuer shall offer such coverage during an individual'…

1. Community rating. This subsection applies to any policy delivered or issued for delivery on or after January 1, 1993. It also applies, as of the first policy or certificate anniversary on or after January 1, 1993, to policies or certificates delivered or issued for delivery in…

During a guaranteed issue period of at least one month each calendar year, as established by the issuer, every issuer shall offer standardized Medicare Supplement Plan A, as defined by rule, to all applicants on a basis that does not deny coverage to any individual or group based…

Any individual accident and sickness insurance policy or group insurance certificate, including the contract of a nonprofit hospital and medical service or health care plan issued for delivery in this State to persons eligible for Medicare, must notify insureds that the policy or…

1. Penalties. In addition to any other applicable penalties for violations of this Title or Title 24, the superintendent may order issuers violating any provision of this chapter or any rule adopted pursuant to this chapter to: A. Comply with the provisions of this chapter; or [P…

1. Notice of cancellation. An insurer that issues Medicare supplement policies shall provide notification to the insured person and another person, if designated by the insured, prior to cancellation of a Medicare supplement policy for nonpayment of premiums. 2. Right to reinstat…

As used in this chapter, unless the context indicates otherwise, the following terms have the following meanings. [PL 1985, c. 648, §12 (NEW).] 1. Long-term care policy. "Long-term care policy" means a group or individual policy of health insurance, a subscriber contract of a non…

1. Prohibited provisions. A long-term care policy may not: A. Contain coverage for skilled nursing facilities only; [PL 1989, c. 556, Pt. B, §3 (NEW).] B. Exclude coverage for skilled, intermediate or custodial care received by a resident of a skilled nursing or intermediate care…

1. Innovative long-term care products permitted. Notwithstanding section 5051‑A, an insurer, organization or plan may offer a long-term care policy, within the meaning of section 5051, subsection 1, which does not meet one or more of the requirements of section 5051‑A if the Supe…

1. Standards for long-term care, home health care and nursing home care policies. The superintendent may adopt rules to establish specific standards for policy provisions of long-term care, home health care and nursing home care policies. The standards must be in addition to and …

Nursing home care, home health care and long-term care policies must have a notice prominently printed on the first page of the policy or certificate or attached to the first page stating in substance that the applicant has the right to return the policy or certificate within 30 …

The superintendent may adopt reasonable rules to provide for the full and fair disclosure of information in connection with the sale of long-term care, home health care and nursing home care policies, including, but not limited to, an outline of coverage requirements and requirem…

1. Filing of form. Any insurer, nonprofit hospital or medical service organization, or nonprofit health care plan may, at the time it files a policy or contract for approval for issuance or delivery in the State, or at any time thereafter, request that the superintendent certify …

1. Reduced premium tax. Any insurance company choosing to offer an insurance policy which is certified by the superintendent as a long-term care policy shall qualify for the reduced tax on premiums collected under Title 36, section 2513. 2. Income tax reduction. Any person paying…

Every insurer, health care service plan or other entity marketing nursing home care, home health care or long-term care insurance coverage in this State, directly or through its producers, shall: [PL 1997, c. 604, Pt. D, §7 (AMD).] 1. Policy comparison. Establish marketing proced…

This chapter applies only to policies and certificates issued before January 1, 2000.

This chapter applies to long-term care insurance policies or certificates delivered or issued for delivery in this State on or after January 1, 2000, except it does not apply to certificates issued under policies issued in other states to employer groups as described in section 2…

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1999, c. 292, §2 (NEW).] 1. Applicant. "Applicant" means: A. In the case of an individual long-term care insurance policy, the person who seeks to contract for be…

1. Groups other than employer, union, trustee and association groups. A group long-term care insurance policy may not be offered to a resident of this State under a group policy issued in another state to a group other than an employer group as described in section 2804, a labor …

The following standards apply to disclosures relating to long-term care insurance. [PL 1999, c. 292, §2 (NEW).] 1. Disclosures. The superintendent may adopt rules that include standards for full and fair disclosure setting forth the manner, content and required disclosures for th…

1. Prohibitions. A long-term care insurance policy or certificate may not: A. Be canceled, nonrenewed or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual; [PL 1999, c. 292, §2 (NEW).] B. Contain a provi…

1. Filing of form. An insurer, nonprofit hospital or medical service organization or nonprofit health care plan may request, at the time it files a policy or contract for approval for issuance or delivery in the State or at any time thereafter, that the superintendent certify the…

1. Policies or certificates in effect for less than 6 months. For a policy or certificate that has been in effect for less than 6 months, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showi…

1. Offer required. Except as provided in subsection 2, a long-term care insurance policy or certificate may not be delivered or issued for delivery in this State unless the policyholder or certificate holder has been offered the option of purchasing a policy or certificate that i…

The superintendent shall adopt rules to promote premium adequacy, to protect a policyholder and a certificate holder in the event of substantial rate increases and to establish minimum standards for marketing practices, insurance producer compensation, insurance producer educatio…

In addition to any other penalties provided by this Title or the laws of this State, an insurer or insurance producer that violates any requirement of this chapter or rule adopted pursuant to this chapter relating to the regulation of long-term care insurance or the marketing of …

This chapter applies to long-term care policies and certificates issued or delivered in this State on or after January 1, 2000. Policies and certificates issued prior to January 1, 2000 and remaining in effect on that date are subject to the requirements of chapter 68. Those poli…

1. Training required. An individual may not sell, solicit or negotiate long-term care insurance unless: A. The individual is licensed as a life or health insurance producer; [PL 2007, c. 232, §3 (NEW).] B. The individual has completed a one-time training course that is no less th…

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Eligible policyholder" means: (1) An individual who holds a qualified individual policy issued before or during the notice period by an insurer th…

1. Notice of claim for benefits; response by insured. Notwithstanding any other provision of this Title, upon receipt of a notice of claim for benefits under a policy or certificate of long-term care insurance delivered or issued for delivery in this State, an insurer, whether ac…

1. Notice. An insurer shall notify a policyholder of a long-term care insurance policy issued in accordance with this chapter or chapter 68 of a proposed premium rate increase that affects the policyholder no later than 30 days after the filing by the insurer of the premium rate …

This chapter shall be known and may be cited as the Maine Liability Risk Retention Act.

The purpose of this Act is to regulate the formation and operation of risk retention groups and purchasing groups in this State formed pursuant to the provisions of the Risk Retention Amendments of 1986, United States Code, Title 15, Section 3901, et seq., to the extent permitted…

As used in this Act, unless the context indicates otherwise, the following terms have the following meanings. [PL 1987, c. 481, §3 (NEW).] 1. Completed operations liability. "Completed operations liability" means liability arising out of the installation, maintenance or repair of…