§4341. Limitations on premium transfer
The superintendent may deny a request for waiver based on any of the following characteristics: [PL 1999, c. 609, §20 (NEW).]
1. Transfer of 30% of annual aggregate premium. A contract by which 30% or more of the carrier's annual aggregate premium with respect to a contract, plan or product is transferred to a single downstream entity. This transfer is the sum of capitated payments plus the sum of amounts returnable to the carrier through incentive payments or other risk adjustments; or
[PL 1999, c. 609, §20 (NEW).]
2. Transfer of 75% of annual aggregate premium. Multiple contracts by which 75% or more of the carrier's annual aggregate premium with respect to a contract, plan or product is transferred to one or more downstream entities. This transfer is the sum of capitated payments plus the sum of amounts returnable to the carrier through incentive payments or other risk adjustments.
[PL 1999, c. 609, §20 (NEW).]
SECTION HISTORY
PL 1999, c. 609, §20 (NEW).
Structure Maine Revised Statutes
TITLE 24-A: MAINE INSURANCE CODE
Chapter 56-A: HEALTH PLAN IMPROVEMENT ACT
24-A §4332. Safe harbor and waiver
24-A §4333. Requirements for downstream risk arrangements
24-A §4334. Substantial insurance risk; substantial enrollment risk
24-A §4335. Contractual provisions
24-A §4336. Disclosure requirements for organizations with downstream risk arrangements
24-A §4337. Requirements related to subcontracting arrangements
24-A §4338. Downstream risk arrangements that exceed risk threshold described in section 4334
24-A §4339. Contractual provisions to demonstrate financial viability
24-A §4340. Financial viability
24-A §4341. Limitations on premium transfer