§2834-B. Dependent special enrollment period
1. Application. This section applies to all group and blanket medical insurance policies issued by nonprofit hospital or medical service organizations, insurers or health maintenance organizations except hospital indemnity, specified accident, specified disease and long-term care policies.
[PL 1997, c. 445, §19 (NEW); PL 1997, c. 445, §32 (AFF).]
2. Definition. For purposes of this section, an "eligible individual" is a person who is a certificate holder under the policy or who has met any waiting period applicable to becoming a certificate holder and is eligible to be enrolled under the policy but for a failure to enroll during a previous enrollment period.
[PL 1997, c. 445, §19 (NEW); PL 1997, c. 445, §32 (AFF).]
3. Requirement. If a policy makes coverage available with respect to dependents of certificate holders, the policy must provide for a dependent special enrollment period when a person becomes a dependent of an eligible individual through marriage, birth or adoption or placement for adoption, if a court order is issued changing custody of a child or if a dependent who has other coverage loses eligibility under that coverage. During this period, the dependent may be enrolled under the plan as a dependent of the eligible individual and, in the case of the birth or adoption of a child, the spouse of the eligible individual may be enrolled as a dependent if otherwise eligible for coverage. If the eligible individual is not already enrolled or is enrolled in a different benefit package, the individual may enroll during this period.
[PL 2007, c. 199, Pt. A, §1 (AMD).]
4. Length of period. A dependent special enrollment period under this section must be a period of not less than 30 days and must begin on the latest of:
A. The date dependent coverage is made available; [PL 2007, c. 199, Pt. A, §2 (AMD).]
B. The date of the marriage, birth or adoption or placement for adoption or the date of the court order; and [PL 2007, c. 199, Pt. A, §2 (AMD).]
C. The date a dependent loses other coverage. [PL 2007, c. 199, Pt. A, §2 (NEW).]
[PL 2007, c. 199, Pt. A, §2 (AMD).]
5. No waiting period. If an individual seeks to enroll a dependent during the first 30 days of a dependent special enrollment period, the coverage of the dependent becomes effective:
A. In the case of marriage, no later than the first day of the first month beginning after the date the completed request for enrollment is received; [PL 1997, c. 445, §19 (NEW); PL 1997, c. 445, §32 (AFF).]
B. In the case of a dependent's birth, as of the date of the birth; [PL 1999, c. 256, Pt. B, §3 (AMD).]
C. In the case of a dependent's adoption or placement for adoption, as of the date of the adoption or placement for adoption; [PL 2007, c. 199, Pt. A, §3 (AMD).]
D. In the case of a court order changing custody of a child, as of the date of the order; or [PL 2007, c. 199, Pt. A, §3 (AMD).]
E. In the case of a dependent who loses other coverage, as of the date of application for enrollment. [PL 2007, c. 199, Pt. A, §3 (NEW).]
[PL 2007, c. 199, Pt. A, §3 (AMD).]
SECTION HISTORY
PL 1997, c. 445, §19 (NEW). PL 1997, c. 445, §32 (AFF). PL 1999, c. 256, §§B1-4 (AMD). PL 2007, c. 199, Pt. A, §§1-3 (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