1. Guaranteed access reinsurance mechanism established. The Maine Guaranteed Access Reinsurance Association is established as a nonprofit legal entity. As a condition of doing business in the State, an insurer that has issued or administered medical insurance within the previous 12 months or is actively marketing a medical insurance policy or medical insurance administrative services in this State must participate in the association. The association may operate a reinsurance program contingent on the approval of, or continued approval of, a state innovation waiver under Section 1332 of the federal Affordable Care Act submitted by the superintendent as provided for in section 2781.
A. [PL 2019, c. 653, Pt. B, §12 (RP).]
B. [PL 2019, c. 653, Pt. B, §12 (RP).]
C. [PL 2019, c. 653, Pt. B, §12 (RP).]

[PL 2019, c. 653, Pt. B, §12 (AMD).]

Terms Used In Maine Revised Statutes Title 24-A Sec. 3953

  • Association: means the Maine Guaranteed Access Reinsurance Association under section 3953. See Maine Revised Statutes Title 24-A Sec. 3952
  • Board: means the Board of Directors of the Maine Guaranteed Access Reinsurance Association under section 3953, subsection 2. See Maine Revised Statutes Title 24-A Sec. 3952
  • federal Affordable Care Act: means the federal Patient Protection and Affordable Care Act, Public Law 111-148, as amended by the federal Health Care and Education Reconciliation Act of 2010, Public Law 111-152, and any amendments to or regulations or guidance issued under those acts. See Maine Revised Statutes Title 24-A Sec. 14
  • health insurance: means insurance of human beings against bodily injury, disablement or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness, and every insurance appertaining thereto, including provision for the mental and emotional welfare of human beings by defraying the costs of legal services only to the extent provided for in chapter 38. See Maine Revised Statutes Title 24-A Sec. 704
  • insurer: includes an insurance company, a nonprofit hospital and medical service organization, a fraternal benefit society, a health maintenance organization, a self-insured employer subject to state regulation as described in section 2848?A, a 3rd-party administrator, a multiple-employer welfare arrangement, a reinsurer that reinsures health insurance in this State or a captive insurance company established pursuant to chapter 83 that insures the health coverage risks of its members. See Maine Revised Statutes Title 24-A Sec. 3952
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Medical insurance: means a hospital and medical expense-incurred policy, nonprofit hospital and medical service plan, health maintenance organization subscriber contract or other health care plan or arrangement that pays for or furnishes medical or health care services whether by insurance or otherwise, whether sold as an individual or group policy. See Maine Revised Statutes Title 24-A Sec. 3952
  • Producer: means a person who is licensed to sell health insurance in this State. See Maine Revised Statutes Title 24-A Sec. 3952
2. Board of directors. The association is governed by the Board of Directors of the Maine Guaranteed Access Reinsurance Association established under Title 5, section 12004?G, subsection 14?H.
A. The board consists of 12 members appointed as described in this paragraph:

(1) Seven members appointed by the superintendent: 2 members chosen from the general public and who are not associated with the medical profession, a hospital, an insurer or a producer; 2 members who represent medical providers; one member who represents individual health insurance consumers who is not associated or formerly associated with the medical profession, a hospital, an insurer or a producer; one member who represents a statewide organization that represents small businesses; and one member who represents producers. A board member appointed by the superintendent may not be removed without cause; and
(2) Five members appointed by the member insurers, at least one of whom is a domestic insurer and at least one of whom is a 3rd-party administrator. [PL 2013, c. 273, §2 (AMD).]
B. Members of the board serve for 3-year terms. Members of the board may serve up to 3 consecutive terms. [PL 2011, c. 90, Pt. B, §8 (NEW).]
C. The board shall elect one of its members as chair. [PL 2011, c. 90, Pt. B, §8 (NEW).]
D. Board members may be reimbursed from funds of the association for actual and necessary expenses incurred by them as members but may not otherwise be compensated for their services. [PL 2011, c. 90, Pt. B, §8 (NEW).]
E. The board shall establish regular places and times for meetings and may meet at other times at the call of the chair. The board shall post notice of scheduled meetings, meeting agendas and minutes of meetings on a publicly accessible website maintained by the association. [PL 2013, c. 273, §3 (NEW).]
F. The board shall establish a mechanism on its publicly accessible website for the public to submit comments on matters related to the operations of the association. [PL 2013, c. 273, §3 (NEW).]
G. The board shall establish a process for taking public comment at selected board meetings to be held at such time and place as the board may determine. The opportunity for public comment must be made available not less often than quarterly. Except as specified in this paragraph, meetings of the board are not open to the public. [PL 2013, c. 273, §3 (NEW).]

[PL 2013, c. 273, §§2, 3 (AMD).]

3. Plan of operation; rules. The board shall adopt a plan of operation in accordance with the requirements of this chapter and submit its articles, bylaws and operating rules to the superintendent for approval. If the board fails to adopt the plan of operation and suitable articles and bylaws within 90 days after the appointment of the board, the superintendent shall adopt rules to effectuate the requirements of this chapter and those rules remain in effect until superseded by a plan of operation and articles and bylaws submitted by the board and approved by the superintendent. Rules adopted by the superintendent pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2?A.

[PL 2011, c. 90, Pt. B, §8 (NEW).]

4. Immunity. A board member is not liable and is immune from suit at law or equity for any conduct performed in good faith that is within the scope of the board’s jurisdiction.

[PL 2011, c. 90, Pt. B, §8 (NEW).]

SECTION HISTORY

PL 2011, c. 90, Pt. B, §8 (NEW). PL 2013, c. 273, §§1-3 (AMD). PL 2015, c. 404, §1 (AMD). PL 2017, c. 124, §1 (AMD). PL 2019, c. 653, Pt. B, §12 (AMD).