Maine Revised Statutes
Chapter 35: GROUP AND BLANKET HEALTH INSURANCE
24-A §2834-B. Dependent special enrollment period

§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

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. Requirements

24-A §2803-A. Loss information

24-A §2804. Employee groups

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 §2806. Trustee groups

24-A §2807. Debtor groups

24-A §2807-A. Credit union groups

24-A §2808. Other 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 §2816. Requirements

24-A §2817. Applicant's statements; waivers, amendments

24-A §2818. Statements in application

24-A §2819. New employees, members

24-A §2820. Renewal of policy

24-A §2821. Individual certificates

24-A §2822. Age limits

24-A §2823. Notice of claim

24-A §2823-A. Explanation and notice to parent

24-A §2823-B. Standardized claim forms

24-A §2824. Proof of loss

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 §2828. Time for suits

24-A §2829. Exceptions

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. Maternity benefits for unmarried women certificate holders and the minor dependents of certificate holders with dependent or family coverage required

24-A §2832-A. Mandated offer of domestic partner benefits

24-A §2833. Child coverage

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. Rates filed

24-A §2839-A. Notice of rate increase

24-A §2839-B. Large group rates

24-A §2840. Optional coverage for chiropractic services (REALLOCATED FROM TITLE 24-A, SECTION 2746) (REPEALED)

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-B. Jury service

24-A §2847-C. Notification prior to cancellation; restrictions on cancellation, termination or lapse due to cognitive impairment or functional incapacity

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-H. Coverage for services of certified nurse practitioners; certified midwives; certified nurse midwives (REALLOCATED FROM TITLE 24-A, SECTION 2847-G)

24-A §2847-I. Coverage for services provided by registered nurse first assistants (REALLOCATED FROM TITLE 24-A, SECTION 2847-G)

24-A §2847-J. Coverage for hospice care services

24-A §2847-K. Coverage for general anesthesia for dentistry (REALLOCATED FROM TITLE 24-A, SECTION 2847-J)

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-P. Coverage for medically necessary infant formula (REALLOCATED FROM TITLE 24-A, SECTION 2847-N)

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-S. Coverage for children's early intervention services (REALLOCATED FROM TITLE 24-A, SECTION 2847-R)

24-A §2847-T. Coverage for the diagnosis and treatment of autism spectrum disorders (REALLOCATED FROM TITLE 24-A, SECTION 2847-R)

24-A §2847-U. Coverage for services provided by dental therapist

24-A §2847-V. Absolute discretion clauses

24-A §2847-W. Dental benefit waiting period