2011 Maine Revised Statutes
TITLE 24-A: MAINE INSURANCE CODE
Chapter 54-A: MAINE GUARANTEED ACCESS REINSURANCE ASSOCIATION ACT
24-A §3961. Reimbursement of member insurer

§3961. Reimbursement of member insurer

1. Reimbursement. A member insurer may seek reimbursement from the association and the association shall reimburse the member insurer to the extent claims made by a covered person on a calendar year basis after July 1, 2012 exceed the amounts otherwise eligible for reimbursement pursuant to section 3958, subsection 1, paragraph A, if:

A. The member insurer sold an individual health plan to the covered person between December 1, 1993 and July 1, 2012, the individual health plan that was sold has been continuously renewed by the covered person and the member insurer has closed its book of business for individual health plans sold between December 1, 1993 and July 1, 2012; and [2011, c. 90, Pt. B, §8 (NEW).]

B. The member insurer is able to determine through the use of individual health statements, claims history, risk scores or any reasonable means that, between December 1, 1993 and July 1, 2012, while the person received coverage under an individual health plan issued by the member insurer, the covered person would have been designated by the member insurer pursuant to section 3959, subsection 1. [2011, c. 90, Pt. B, §8 (NEW).]

[ 2011, c. 90, Pt. B, §8 (NEW) .]

2. Rules. The superintendent may adopt rules to facilitate payment to a member insurer pursuant to this section. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.

[ 2011, c. 90, Pt. B, §8 (NEW) .]

SECTION HISTORY

2011, c. 90, Pt. B, §8 (NEW).