§2808. Other groups
Group health insurance offered to a resident of this State under a group health insurance policy issued to a group other than one described in sections 2804 to 2807‑A is subject to the following requirements. [PL 1981, c. 147, §8 (RPR).]
1. No group health insurance policy may be delivered in this State, pursuant to this section, unless the superintendent finds that:
A. The policyholder is a bona fide group formed for purposes other than procurement of insurance; [PL 1987, c. 476, §4 (AMD).]
B. The issuance of the group policy would be actuarially sound; [PL 1981, c. 147, §8 (NEW).]
C. The issuance of the group policy would result in economies of acquisition or administration; and [PL 1987, c. 476, §4 (AMD).]
D. The benefits are reasonable in relation to the premiums charged. [PL 1981, c. 147, §8 (NEW).]
[PL 1987, c. 476, §4 (AMD).]
2. No group health insurance coverage may be offered in this State, pursuant to this section, by an insurer under a policy issued in another state, unless the superintendent has made a determination that the requirements of subsection 1, paragraphs A, B, C and D have been met.
[PL 1987, c. 476, §5 (RPR).]
2-A. Notwithstanding subsections 1 and 2, an employee leasing company registered pursuant to Title 32, chapter 125 qualifies as an eligible group for purposes of the purchase of group health insurance as provided in this section.
[PL 1997, c. 393, Pt. A, §26 (AMD).]
3. The premium for the policy shall be paid either from the policyholder's funds or from funds contributed by the covered persons, or from both.
[PL 1981, c. 147, §8 (NEW).]
4. Except as provided in section 2736‑C, section 2808‑B and chapter 36, an insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer.
[PL 1999, c. 256, Pt. G, §6 (AMD).]
SECTION HISTORY
PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD). PL 1981, c. 147, §8 (RPR). PL 1987, c. 476, §§4,5 (AMD). PL 1989, c. 867, §§7,10 (AMD). PL 1995, c. 618, §3 (AMD). PL 1997, c. 393, §A26 (AMD). PL 1999, c. 256, §G6 (AMD).
Structure Maine Revised Statutes
TITLE 24-A: MAINE INSURANCE CODE
Chapter 35: GROUP AND BLANKET HEALTH INSURANCE
24-A §2801. Scope of chapter -- short title
24-A §2802. Group insurance defined
24-A §2803-A. Loss information
24-A §2804-A. Private purchasing alliances
24-A §2804-B. Group disability income protection plan
24-A §2805. Labor union groups
24-A §2805-A. Association groups
24-A §2807-A. Credit union groups
24-A §2808-A. Rating practices in group health insurance (REPEALED)
24-A §2808-B. Small group health plans
24-A §2809. Coverage of family, dependents; continuation of coverage
24-A §2809-A. Conversion on termination of policy or eligibility
24-A §2810. Group health insurance payments; beneficiaries
24-A §2811. Payment of expenses
24-A §2812. Readjustment of premium rate (REPEALED)
24-A §2812-A. Dividends and experience refunds
24-A §2813. "Blanket health insurance" defined
24-A §2814. Blanket health insurance; payments; beneficiaries
24-A §2815. Legal liability of policyholders
24-A §2817. Applicant's statements; waivers, amendments
24-A §2818. Statements in application
24-A §2819. New employees, members
24-A §2821. Individual certificates
24-A §2823-A. Explanation and notice to parent
24-A §2823-B. Standardized claim forms
24-A §2825. Forms for proof of loss
24-A §2826. Examination, autopsy
24-A §2827. Time for payment of benefits
24-A §2827-A. Assignment of benefits
24-A §2829-A. Disability benefit offsets
24-A §2830. Omissions, modifications: superintendent may approve
24-A §2831. Hospital, medical benefits; direct payment
24-A §2832-A. Mandated offer of domestic partner benefits
24-A §2833-A. Extension of coverage for dependent children
24-A §2833-B. Mandatory offer to extend coverage for dependent children up to 26 years of age
24-A §2833-C. Mandatory offer of coverage for certain adults with disabilities
24-A §2834. Newborn children coverage
24-A §2834-A. Maternity and routine newborn care
24-A §2834-B. Dependent special enrollment period
24-A §2834-C. Compliance with federal law
24-A §2834-D. Maternity and postpartum care
24-A §2835. Mental health services
24-A §2836. Limits on priority liens
24-A §2837. Home health care coverage
24-A §2837-A. Screening mammograms
24-A §2837-B. Acupuncture services
24-A §2837-C. Coverage for breast cancer treatment
24-A §2837-D. Medical food coverage for inborn error of metabolism
24-A §2837-E. Coverage for Pap tests
24-A §2837-F. Off-label use of prescription drugs for cancer
24-A §2837-G. Off-label use of prescription drugs for HIV or AIDS
24-A §2837-H. Coverage for prostate cancer screening (REALLOCATED FROM TITLE 24-A, SECTION 2837-F)
24-A §2838. Community health service coverage (REPEALED)
24-A §2839-A. Notice of rate increase
24-A §2839-B. Large group rates
24-A §2840-A. Coverage for chiropractic services
24-A §2841. Optional coverage for optometric services
24-A §2842. Equitable health care for substance use disorder treatment
24-A §2843. Mental health services coverage
24-A §2844. Coordination of benefits
24-A §2845. Cardiac rehabilitation coverage
24-A §2846. Acquired Immune Deficiency Syndrome
24-A §2847. Utilization review data
24-A §2847-A. Penalty for failure to notify of hospitalization
24-A §2847-D. Penalty for noncompliance with utilization review programs
24-A §2847-E. Coverage for diabetes supplies
24-A §2847-F. Gynecological and obstetrical services (REALLOCATED FROM TITLE 24-A, SECTION 2850-A)
24-A §2847-G. Coverage for contraceptives
24-A §2847-J. Coverage for hospice care services
24-A §2847-L. Offer of coverage for breast reduction surgery and symptomatic varicose vein surgery
24-A §2847-M. Enrollment for individuals or families establishing eligibility for MaineCare
24-A §2847-N. Coverage for colorectal cancer screening
24-A §2847-O. Coverage for hearing aids (REALLOCATED FROM TITLE 24-A, SECTION 2847-M)
24-A §2847-Q. Coverage for services provided by independent practice dental hygienist
24-A §2847-R. Enrollment of dependent children in dental coverage
24-A §2847-U. Coverage for services provided by dental therapist