§2321. Rate filings on individual subscriber and membership contracts
1. Filing of rate information. Every nonprofit hospital and medical service organization shall file with the superintendent every rate, rating formula and every modification of any of the foregoing that it proposes to use in connection with individual health insurance contracts, group Medicare supplement contracts as defined in Title 24‑A, chapter 67, group nursing home or long-term care contracts as defined in Title 24‑A, chapter 68 or 68‑A, and certain group contracts included within the definition of "individual health plan" in Title 24‑A, section 2736‑C, subsection 1, paragraph C. Every filing under this subsection must state the effective date of the filing. Every filing under this subsection must be made not less than 60 days in advance of the stated effective date unless the 60-day requirement is waived by the superintendent for a period of time not to exceed 30 days.
[PL 2009, c. 244, Pt. C, §1 (AMD).]
2. Filing information. When a filing is not accompanied by the information upon which the organization supports such filing, or the superintendent does not have sufficient information to determine whether such filing meets the requirements that the rates not be excessive, inadequate or unfairly discriminatory, the superintendent shall require the organization to furnish the information upon which it supports the filing. A filing and supporting information are public records within the meaning of Title 1, section 402, subsection 3 and become part of the official record of any hearing held pursuant to section 2322. For the purpose of determining whether the filing produces rates that are not excessive, inadequate or unfairly discriminatory, the superintendent and the Attorney General each may employ consultants, including actuaries, and the reasonable costs of the consultants, including actuaries, which must include costs of testifying at any hearing held pursuant to section 2322, must be borne by the organization making such filing. The organization is not responsible for any costs from the Attorney General exceeding $40,000 for any filing.
[PL 1997, c. 344, §6 (AMD).]
3. Three-year review.
[PL 1997, c. 344, §6 (RP).]
4. Criteria for special rate hearings.
[PL 2009, c. 244, Pt. C, §2 (RP).]
5. Special rate hearing.
[PL 2009, c. 244, Pt. C, §3 (RP).]
SECTION HISTORY
PL 1977, c. 493, §2 (NEW). PL 1979, c. 558, §§1,2 (AMD). PL 1985, c. 648, §1 (AMD). PL 1991, c. 9, §G5 (AMD). PL 1991, c. 48, §§1,2 (AMD). PL 1997, c. 344, §6 (AMD). PL 2001, c. 432, §§2,3 (AMD). PL 2003, c. 428, §F1 (AMD). PL 2009, c. 244, Pt. C, §§1-3 (AMD).
Structure Maine Revised Statutes
Chapter 19: NONPROFIT HOSPITAL OR MEDICAL SERVICE ORGANIZATIONS
Subchapter 1: GENERAL PROVISIONS
24 §2301-A. Continuity of licensure; business combinations
24 §2302-A. Utilization review data
24 §2302-B. Penalty for failure to notify of hospitalization
24 §2302-C. Penalty for noncompliance with utilization review programs
24 §2303. Mental health services
24 §2303-A. Dentist included in definition of physician (REPEALED)
24 §2303-B. Optional coverage for chiropractic services (REPEALED)
24 §2303-C. Coverage for chiropractic services (REPEALED)
24 §2305-A. Conditions of certificate of authority
24 §2307-B. Loss information (REPEALED)
24 §2308. Investments (REPEALED)
24 §2308-A. Health insurance affiliates
24 §2313. Licenses; fees (REPEALED)
24 §2314. Suspension or revocation of certificate of authority
24 §2316. Certificates or contracts; approval by superintendent
24 §2317. Other provisions applicable
24 §2317-A. Explanation and notice to parent of minor (REPEALED)
24 §2317-B. Applicability of provisions
24 §2318. Maternity benefits and dependent coverage
24 §2318-A. Maternity and routine newborn care
24 §2319. Newborn children coverage
24 §2319-A. Mandated offer of domestic partner benefits
24 §2320. Home health care coverage
24 §2320-A. Screening mammograms
24 §2320-B. Acupuncture services
24 §2320-C. Coverage for breast cancer treatment
24 §2320-D. Medical food coverage for inborn error of metabolism
24 §2320-E. Coverage for Pap tests
24 §2320-F. Off-label use of prescription drugs for cancer
24 §2320-G. Off-label use of prescription drugs for HIV or AIDS
24 §2321. Rate filings on individual subscriber and membership contracts
24 §2321-A. Standards for when filings are inadequate
24 §2321-B. Appropriate level of subscriber reserves
24 §2324. Certified ambulatory health care center outpatient coverage
24 §2325. Community health services coverage (REPEALED)
24 §2325-A. Mental health services coverage
24 §2325-B. Mandated Benefits Advisory Commission (REPEALED)
24 §2325-C. Coverage for prostate cancer screening
24 §2326. Appeals from order or decision of the superintendent
24 §2327-A. Applicability (REPEALED)
24 §2327-B. Rating practices in individual insurance (REPEALED)
24 §2327-C. Continuity of health insurance coverage (REPEALED)
24 §2329. Equitable health care for substance use disorder treatment
24 §2330. Conversion on termination of contracts or eligibility (REPEALED)
24 §2331. Optional coverage for optometric services
24 §2332-A. Coordination of benefits
24 §2332-B. Acquired Immune Deficiency Syndrome
24 §2332-C. Assessment of mandated benefits proposals (REPEALED)
24 §2332-E. Standardized claim forms
24 §2332-F. Coverage for diabetes supplies
24 §2332-G. Gynecological and obstetrical services (REALLOCATED FROM TITLE 24, SECTION 2332-F)
24 §2332-H. Assignment of benefits
24 §2332-I. Effective date of cancellation
24 §2332-J. Coverage for contraceptives
24 §2332-M. Coverage for general anesthesia for dentistry
24 §2332-N. Offer of coverage for breast reduction surgery and symptomatic varicose vein surgery