Maine Revised Statutes Title 24-A Sec. 2678 – Annual experience report
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On or before April 1st of each year, an administrator or carrier who issues or administers a program, policy or contract in this State that includes incentives for the enrollee to use the services of a provider who has entered into an agreement with the carrier or administrator shall file a report of its activities for the preceding year with the superintendent. The report must be in the form prescribed by the superintendent and at a minimum must contain the following: [PL 1999, c. 609, §15 (AMD).]
1. A provider directory that includes the name, address and scope of license of each preferred provider; and
[PL 1999, c. 609, §15 (AMD).]
Terms Used In Maine Revised Statutes Title 24-A Sec. 2678
- Administrator: means any person, other than a carrier, that administers a preferred provider arrangement. See Maine Revised Statutes Title 24-A Sec. 2671
- Carrier: means an insurance company licensed in accordance with this Title, a fraternal benefit society authorized pursuant to chapter 55 or a nonprofit hospital or medical service organization licensed pursuant to Title 24. See Maine Revised Statutes Title 24-A Sec. 2671
- Contract: A legal written agreement that becomes binding when signed.
- Enrollee: means an individual entitled to reimbursement for expenses of health care services under a health plan. See Maine Revised Statutes Title 24-A Sec. 2671
- Preferred provider: means a provider who enters into a preferred provider arrangement with an administrator or carrier. See Maine Revised Statutes Title 24-A Sec. 2671
- Provider: means an individual or entity duly licensed or otherwise legally authorized to provide health care services, including, but not limited to, the treatment of physical health and mental health and provision for medical supplies and pharmaceutical supplies. See Maine Revised Statutes Title 24-A Sec. 2671
- Superintendent: means the Superintendent of Insurance. See Maine Revised Statutes Title 24-A Sec. 2671
- Year: means a calendar year, unless otherwise expressed. See Maine Revised Statutes Title 1 Sec. 72
2.
[PL 1999, c. 609, §15 (RP).]
3. Annual information specified in chapter 56?A or rules adopted under that chapter. Annual information reported to the superintendent pursuant to chapter 56?A under another license must be referenced in the report and not reported in a duplicate manner.
[PL 1999, c. 609, §15 (NEW).]
SECTION HISTORY
PL 1985, c. 704, §4 (NEW). PL 1999, c. 609, §15 (AMD).