§5001-A. Applicability and scope 1. Application. Except as otherwise specifically provided in section 5013, this chapter applies to: A. All Medicare supplement policies delivered or issued for delivery in this State on or after the effective date of this section; and [PL 1991, c. 740, §2 (NEW).] B. All certificates issued under group […]
§5001. Definitions As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1981, c. 234, §4 (NEW).] 1. Applicant. “Applicant” means: A. In the case of an individual Medicare supplement policy, the person who seeks to contract for insurance benefits; and [PL 1991, c. […]
§5002-A. Standards for policy provisions and authority to adopt rules 1. Duplicate benefits. A Medicare supplement policy or certificate in force in the State may not contain benefits that duplicate benefits provided by Medicare. [PL 1991, c. 740, §4 (NEW).] 2. Standardization. The superintendent may adopt rules specifying the minimum Medicare supplement contract benefits […]
§5002-B. Continuity of coverage 1. Persons provided continuity of coverage. This section provides continuity of coverage for a person who has a Medicare supplement policy and seeks coverage under a new Medicare supplement policy with the same or lesser benefits if: A. That person, including a person entitled to Medicare benefits due to disability, […]
§5002. Standards for policy provisions (REPEALED) SECTION HISTORY PL 1981, c. 234, §4 (NEW). PL 1989, c. 27, §3 (AMD). PL 1991, c. 24, §1 (AMD). PL 1991, c. 48, §3 (AMD). PL 1991, c. 740, §3 (RP).
§5003. Minimum standards for benefits (REPEALED) SECTION HISTORY PL 1981, c. 234, §4 (NEW). PL 1989, c. 852, §1 (AMD). PL 1991, c. 740, §5 (RP).
§5004. Loss ratio standards 1. Any Medicare supplement policy or contract is subject to the minimum loss ratio standards of section 2413, subsection 1, paragraph F, as well as any other laws of this State as apply to rate filings with respect to health insurance and nonprofit hospital and medical service organizations and nonprofit health […]
§5005. Disclosure standards 1. Delivery of outline of coverage. In order to provide for full and fair disclosure in the sale of Medicare supplement policies, no Medicare supplement policy or certificate may be delivered in this State, unless an outline of coverage is delivered to the applicant at the time application is made. [PL […]
§5006-A. Filing requirements for advertising Every issuer of Medicare supplement insurance policies or certificates in this State shall provide a copy of any Medicare supplement advertisement intended for use in this State, whether through written, radio or television medium, to the superintendent for review or approval by the superintendent at least 30 days prior to […]
§5006. Preexisting conditions (REPEALED) SECTION HISTORY PL 1981, c. 234, §4 (NEW). PL 1991, c. 740, §8 (RP).
§5007. Notice of free examination Medicare supplement policies and certificates must have a notice prominently printed on the first page of the policy or certificate or attached to the policy or certificate, stating in substance that the applicant has the right to return the policy or certificate within 30 days of its delivery and to […]
§5008. Minimum standards for benefits and claims payment (REPEALED) SECTION HISTORY PL 1989, c. 27, §6 (NEW). PL 1991, c. 740, §11 (RP).
§5009. Filing requirements for advertising (REPEALED) SECTION HISTORY PL 1989, c. 27, §6 (NEW). PL 1991, c. 740, §12 (RP).
§5010-A. Coverage of the disabled An issuer offering coverage under a Medicare supplement policy in this State shall offer coverage under its standardized plans to all individuals, regardless of age, who are entitled to Medicare benefits due to disability. An issuer shall offer such coverage during an individual’s open enrollment period under any of the […]
§5010. Replacement of policies issued prior to January 1, 1992 1. Applicability. This section applies to individual policies and group certificates and policies issued in Maine or covering Maine residents. [PL 1991, c. 740, §13 (NEW).] 2. Insured’s right to replace coverage. Insureds under Medicare supplement policies issued prior to January 1, 1992 shall […]
§5011. Rating restrictions 1. Community rating. This subsection applies to any policy delivered or issued for delivery on or after January 1, 1993. It also applies, as of the first policy or certificate anniversary on or after January 1, 1993, to policies or certificates delivered or issued for delivery in 1992. A. Rates for […]
§5012. Annual guaranteed issue period During a guaranteed issue period of at least one month each calendar year, as established by the issuer, every issuer shall offer standardized Medicare Supplement Plan A, as defined by rule, to all applicants on a basis that does not deny coverage to any individual or group based on health […]
§5013. Notice regarding policies that are not Medicare supplement policies Any individual accident and sickness insurance policy or group insurance certificate, including the contract of a nonprofit hospital and medical service or health care plan issued for delivery in this State to persons eligible for Medicare, must notify insureds that the policy or certificate is […]
§5014. Additional penalties 1. Penalties. In addition to any other applicable penalties for violations of this Title or Title 24, the superintendent may order issuers violating any provision of this chapter or any rule adopted pursuant to this chapter to: A. Comply with the provisions of this chapter; or [PL 1995, c. 570, […]
§5015. Right to repurchase (REPEALED) SECTION HISTORY PL 1997, c. 370, §D1 (NEW). PL 1999, c. 36, §5 (RP).
