1. Every health maintenance organization licensed under this chapter is considered an insurer for purposes of those provisions of the insurance laws that do not expressly reference health maintenance organizations, but are applicable to health maintenance organizations under this chapter.

[PL 1995, c. 332, Pt. O, §8 (NEW).]

Terms Used In Maine Revised Statutes Title 24-A Sec. 4222-B

  • 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
  • Health maintenance organization: means a public or private organization that is organized under the laws of the Federal Government, this State, another state or the District of Columbia or a component of such an organization, and that:
A. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Provider: means a physician, hospital or person that is licensed or otherwise authorized in this State to furnish health care services. See Maine Revised Statutes Title 24-A Sec. 4202-A
    • 2. The requirements of chapter 36, continuity of health insurance coverage law, apply to health maintenance organizations.

    [PL 1995, c. 332, Pt. O, §8 (NEW).]

    3. The requirements of sections 2736?C and 2808?B, community rating law, apply to health maintenance organizations, except that a health maintenance organization is not required to offer coverage or accept applications from an eligible group or individual located outside the health maintenance organization’s approved service area.

    [PL 1995, c. 332, Pt. O, §8 (NEW).]

    4. The requirements of chapter 23 and any rules adopted pursuant to it, to the extent not inconsistent with this chapter and the reasonable implications of this chapter, apply to health maintenance organizations.

    [PL 1995, c. 332, Pt. O, §8 (NEW).]

    5. The requirements of sections 221 to 228, to the extent not inconsistent with this chapter and the reasonable implications of this chapter, apply to domestic health maintenance organizations.

    [PL 2017, c. 169, Pt. A, §12 (AMD).]

    6. The requirements of chapter 57, subchapters I and II apply to health maintenance organizations.

    [PL 2001, c. 88, §6 (AMD).]

    7. The requirements of section 421 apply to health maintenance organizations.

    [PL 1997, c. 457, §50 (AMD).]

    8. The requirements of chapter 32, the Preferred Provider Arrangement Act of 1986, apply to health maintenance organizations only with respect to activities that are not otherwise authorized by chapter 56.

    [PL 1995, c. 332, Pt. O, §8 (NEW).]

    9. The requirements of chapter 56?A and any rules adopted pursuant to that chapter apply to health maintenance organizations.

    [PL 1995, c. 673, Pt. D, §7 (NEW).]

    10. The requirements of section 237 apply to health maintenance organizations, including those operated and organized as a division or line of business of a nonprofit hospital, medical or health care service organization.

    [PL 1997, c. 79, §3 (NEW).]

    11. The requirements of sections 2834 and 2834?B apply to health maintenance organizations.

    [PL 1997, c. 445, §31 (NEW); PL 1997, c. 445, §32 (AFF).]

    12. The requirements of chapter 24 and any rules adopted pursuant to that chapter apply to health maintenance organizations.

    [PL 1997, c. 677, §4 (NEW).]

    13. The requirements of sections 2436 and 2436?A apply to health maintenance organizations.

    [PL 1999, c. 256, Pt. F, §1 (NEW).]

    14. The requirement of filing a report of experience of claims payment for substance use disorder treatment in the format prescribed by section 2842, subsection 9; for chiropractic services in the format prescribed by section 2748, subsection 3 and section 2840?A, subsection 3; and for breast cancer screening services in the format prescribed by section 2745?A, subsection 4 and section 2837?A, subsection 4 applies to health maintenance organizations.

    [PL 2017, c. 407, Pt. A, §97 (AMD).]

    15. The requirements of section 415?A apply to health maintenance organizations.

    [PL 2001, c. 88, §7 (NEW).]

    15. (REALLOCATED TO T. 24-A, §4222-B, sub-§20)

    [RR 2001, c. 1, §35 (RAL).]

    16. The requirements of sections 3483 and 3484 apply to health maintenance organizations.

    [PL 2001, c. 88, §7 (NEW).]

    17. Section 2803?A, relating to disclosure of loss information, applies to health maintenance organizations.

    [PL 2001, c. 410, Pt. B, §3 (NEW).]

    18. The requirement of section 2809?A, subsection 11 to continue group coverage under certain circumstances applies to health maintenance organizations.

    [PL 2001, c. 410, Pt. B, §3 (NEW).]

    19. Section 12?A, relating to penalties, applies to health maintenance organizations.

    [PL 2001, c. 410, Pt. B, §3 (NEW).]

    20. (REALLOCATED FROM T. 24-A, §4222-B, sub-§15) Sections 2735?A and 2839?A, relating to notice of rate filings and rate increases, apply to health maintenance organizations.

    [RR 2001, c. 1, §35 (RAL).]

    21. Section 2723?A, subsection 3 and section 2844, subsection 3 apply to health maintenance organizations.

    [PL 2005, c. 121, Pt. D, §4 (NEW).]

    22. Sections 2713?A and 2823?A, relating to explanation and notice to parents, apply to health maintenance organizations.

    [PL 2009, c. 244, Pt. B, §3 (NEW).]

    23. Section 423?C, relating to reporting of material investment and reinsurance transactions, applies to health maintenance organizations.

    [PL 2017, c. 169, Pt. A, §13 (NEW).]

    24. Section 423?G, relating to corporate governance annual disclosure filings, applies to health maintenance organizations.

    [PL 2017, c. 169, Pt. A, §13 (NEW).]

    SECTION HISTORY

    PL 1995, c. 332, §O8 (NEW). PL 1995, c. 673, §D7 (AMD). PL 1997, c. 79, §3 (AMD). PL 1997, c. 445, §31 (AMD). PL 1997, c. 445, §32 (AFF). PL 1997, c. 457, §50 (AMD). PL 1997, c. 677, §4 (AMD). PL 1999, c. 256, §F1 (AMD). RR 2001, c. 1, §35 (COR). PL 2001, c. 88, §§6,7 (AMD). PL 2001, c. 258, §G3 (AMD). PL 2001, c. 410, §B3 (AMD). PL 2001, c. 432, §8 (AMD). PL 2005, c. 121, §D4 (AMD). PL 2009, c. 244, Pt. B, §3 (AMD). PL 2017, c. 169, Pt. A, §§12, 13 (AMD). PL 2017, c. 407, Pt. A, §97 (AMD).
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