24-A §6901. Short title
§6901. Short title This chapter may be known and cited as “the Dirigo Health Act.” [PL 2003, c. 469, Pt. A, §8 (NEW).] SECTION HISTORY PL 2003, c. 469, §A8 (NEW).
24-A §6902. Dirigo Health established; declaration of necessity
§6902. Dirigo Health established; declaration of necessity Dirigo Health is established as an independent executive agency to arrange for the provision of comprehensive, affordable health care coverage to eligible small employers, including the self-employed, their employees and dependents, and individuals on a voluntary basis. Dirigo Health is also responsible for monitoring and improving the quality […]
24-A §6903. Definitions
§6903. Definitions As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 2003, c. 469, Pt. A, §8 (NEW).] 1. Board. “Board” means the Board of Trustees of Dirigo Health, as established in section 6904. [PL 2007, c. 447, §3 (AMD).] 1-A. Behavioral health care. […]
24-A §6904. Board of Trustees of Dirigo Health
§6904. Board of Trustees of Dirigo Health Dirigo Health operates under the supervision of the Board of Trustees of Dirigo Health established in accordance with this section. [PL 2007, c. 447, §4 (AMD).] 1. Appointments. The board consists of 9 voting members and 3 ex officio, nonvoting members as follows. A. The 9 […]
24-A §6905. Limitation on liability
§6905. Limitation on liability 1. Indemnification of Dirigo Health employees. An employee of Dirigo Health is not subject to any personal liability for having acted within the course and scope of membership or employment to carry out any power or duty under this chapter. Dirigo Health shall indemnify any member of the board and any […]
24-A §6906. Prohibited interests of board members and employees
§6906. Prohibited interests of board members and employees Board members and employees of Dirigo Health and their spouses and dependent children may not receive any direct personal benefit from the activities of Dirigo Health in assisting any private entity, except that they may participate in the Dirigo Health Program on the same terms as others […]
24-A §6907. Confidential records
§6907. Confidential records Except as provided in subsections 1, 2 and 3, information obtained by Dirigo Health under this chapter is a public record within the meaning of Title 1, chapter 13, subchapter 1. [PL 2005, c. 615, §2 (AMD).] 1. Financial information. Any personally identifiable financial information, supporting data or tax return of […]
24-A §6908. Powers and duties of Dirigo Health
§6908. Powers and duties of Dirigo Health 1. Powers. Subject to any limitations contained in this chapter or in any other law, Dirigo Health may: A. Take any legal actions necessary or proper to recover or collect payments due Dirigo Health or that are necessary for the proper administration of Dirigo Health; [PL […]
24-A §6909. Executive director
§6909. Executive director 1. Appointed position. The executive director is appointed by the board and serves at the pleasure of the board. The position of executive director is a major policy-influencing position as designated in Title 5, section 934‑B. [PL 2003, c. 469, Pt. A, §8 (NEW).] 2. Duties of executive director. The executive […]
24-A §6910. Dirigo Health Program
§6910. Dirigo Health Program 1. Dirigo Health Program. Dirigo Health shall arrange for the provision of health benefits coverage through the Dirigo Health Program not later than October 1, 2004. The Dirigo Health Program must comply with all relevant requirements of this Title. Dirigo Health Program coverage may be offered by health insurance carriers that […]
24-A §6911. Coordination with MaineCare
§6911. Coordination with MaineCare The Department of Health and Human Services is the state agency responsible for the financing and administration of MaineCare. It shall pay for MaineCare benefits for MaineCare-eligible individuals, including those enrolled in health plans in MaineCare that are providing coverage under the Dirigo Health Program. An individual participating in the Dirigo […]
24-A §6912. Subsidies
§6912. Subsidies Dirigo Health may establish sliding-scale subsidies for the purchase of Dirigo Health Program coverage paid by eligible individuals or employees whose income is under 300% of the federal poverty level. Dirigo Health may also establish sliding-scale subsidies for the purchase of employer-sponsored health coverage paid by employees of businesses with more than 50 […]
24-A §6913. Savings offset payments against health insurance carriers, employee benefit excess insurance carriers and third-party administrators (REPEALED)
§6913. Savings offset payments against health insurance carriers, employee benefit excess insurance carriers and third-party administrators (REPEALED) SECTION HISTORY PL 2003, c. 469, §A8 (NEW). PL 2005, c. 400, §§A10-13,C9 (AMD). PL 2005, c. 683, §§A43,44 (AMD). PL 2007, c. 1, Pt. X, §§1, 2 (AMD). PL 2007, c. 1, Pt. X, §3 (AFF). PL […]
24-A §6914. Intragovernmental transfer
§6914. Intragovernmental transfer Starting July 1, 2004, and ending September 30, 2012, Dirigo Health shall transfer funds, as necessary, to a special dedicated, nonlapsing revenue account administered by the agency of State Government that administers MaineCare for the purpose of providing a state match for federal Medicaid services provided to individuals eligible pursuant to Title […]
24-A §6915. Dirigo Health Enterprise Fund
§6915. Dirigo Health Enterprise Fund The Dirigo Health Enterprise Fund is created as an enterprise fund for the deposit of any funds advanced for initial operating expenses, payments made by employers and individuals, any savings offset payments made pursuant to former section 6913, any access payments made pursuant to section 6917 and any funds received […]
24-A §6916. Marketing and sale of Dirigo Health Program; qualifications of insurance producers
§6916. Marketing and sale of Dirigo Health Program; qualifications of insurance producers 1. Qualifications of insurance producers. An insurance producer licensed pursuant to chapter 16 may solicit, negotiate and sell insurance products offered by or through the Dirigo Health Program if the following conditions are met prior to any such solicitation, negotiation or sale: […]
24-A §6917. Access payment
§6917. Access payment 1. Access payments required from health insurance carriers, 3rd-party administrators and employee benefit excess insurance carriers. All health insurance carriers, 3rd-party administrators and employee benefit excess insurance carriers shall pay an access payment on all paid claims, except claims under accidental injury, specified disease, hospital indemnity, dental, vision, disability income, long-term care, […]