§4320-M. Coverage for abortion services
1. Required coverage. A carrier offering a health plan in this State that provides coverage for maternity services shall provide coverage for abortion services for an enrollee in accordance with this section.
[PL 2019, c. 274, §5 (NEW).]
2. Limits; deductible; copayment; coinsurance. A health plan that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.
[PL 2019, c. 274, §5 (NEW).]
3. Application. Except for a religious employer granted an exclusion as provided in subsection 4, the requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.
[PL 2019, c. 274, §5 (NEW).]
4. Exclusion for religious employer. A religious employer may request and a carrier shall grant an exclusion under the policy or contract for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains an exclusion under this subsection shall provide prospective enrollees and those individuals insured under its policy written notice of the exclusion. This section may not be construed as authorizing a carrier to exclude coverage for abortion services that are necessary to preserve the life or health of a covered enrollee. For the purposes of this section, "religious employer" means an employer that is a church, a convention or association of churches or an elementary or secondary school that is controlled, operated or principally supported by a church or by a convention or association of churches as defined in 26 United States Code, Section 3121(w)(3)(A) and that qualifies as a tax-exempt organization under 26 United States Code, Section 501(c)(3).
[PL 2019, c. 274, §5 (NEW).]
5. Protection of federal funds. If the superintendent determines enforcement of this section may adversely affect the allocation of federal funds to the State, the superintendent may grant an exemption from the requirements of this section, but only to the minimum extent necessary to ensure the continued receipt of federal funds.
[PL 2019, c. 274, §5 (NEW).]
Revisor's Note: §4320-M. Step therapy as enacted by PL 2019, c. 295, §1 is REALLOCATED TO TITLE 24-A, SECTION 4320-N
SECTION HISTORY
PL 2019, c. 274, §5 (NEW).
Structure Maine Revised Statutes
TITLE 24-A: MAINE INSURANCE CODE
Chapter 56-A: HEALTH PLAN IMPROVEMENT ACT
Subchapter 1: HEALTH PLAN REQUIREMENTS
24-A §4301. Definitions (REPEALED)
24-A §4302. Reporting requirements
24-A §4303-A. Provider profiling programs
24-A §4303-B. Disclosure related to provider networks
24-A §4303-C. Protection from surprise bills and bills for out-of-network emergency services
24-A §4303-D. Provider directories
24-A §4304. Utilization review
24-A §4306. Enrollee choice of primary care provider
24-A §4306-A. Patient access to obstetrical and gynecological care
24-A §4309-A. Compliance with the Affordable Care Act
24-A §4310. Access to clinical trials
24-A §4311. Access to prescription drugs
24-A §4312. Independent external review
24-A §4313. Carrier liability; cause of action
24-A §4314. Access to eye care providers
24-A §4314-A. Coverage for early refills of prescription eye drops
24-A §4315. Coverage of prosthetic devices
24-A §4316. Coverage for telehealth services
24-A §4317. Pharmacy providers
24-A §4317-A. Prescription drug coverage; out-of-pocket expenses for coinsurance
24-A §4317-B. Orally administered cancer therapy
24-A §4317-C. Coverage for prescription insulin drugs; limit on out-of-pocket costs
24-A §4317-D. Coverage of HIV prevention drugs
24-A §4317-E. Coverage for emergency supply of chronic maintenance drugs
24-A §4319-A. Guaranteed issue
24-A §4319-B. Medical loss ratio reporting for dental insurance plans
24-A §4320. No lifetime or annual limits on health plans
24-A §4320-A. Coverage of preventive and primary health services
24-A §4320-B. Extension of dependent coverage
24-A §4320-C. Emergency services
24-A §4320-D. Comprehensive health coverage
24-A §4320-E. Reinsurance, risk corridors and risk adjustment
24-A §4320-G. Applicability to health plans grandfathered under the Affordable Care Act
24-A §4320-H. Payment reform pilot projects (REALLOCATED FROM TITLE 24-A, SECTION 4320)
24-A §4320-I. Coverage for the cost of testing for bone marrow donation suitability
24-A §4320-J. Coverage for abuse-deterrent opioid analgesic drug products
24-A §4320-K. Coverage for services provided by a naturopathic doctor
24-A §4320-L. Nondiscrimination
24-A §4320-M. Coverage for abortion services
24-A §4320-N. Step therapy (REALLOCATED FROM TITLE 24-A, SECTION 4320-M)
24-A §4320-O. Coverage for services provided by a physician assistant
24-A §4320-P. Coverage for health care services for COVID-19
24-A §4320-R. Mandatory offer of coverage for certain adults with disabilities
24-A §4320-S. Coverage for dental services for cancer patients
24-A §4320-U. Coverage for fertility services (REALLOCATED FROM TITLE 24-A, SECTION 4320-S)