1. Approval of forms by superintendent required. A participation agreement or contract form, application form, certificate, rider, endorsement, summary plan description or other evidence of coverage may not be issued by an arrangement unless the form and all changes to the form have been filed with the superintendent by or on behalf of the arrangement that proposes to use the form and have been approved by the superintendent.

[PL 1993, c. 688, §1 (NEW).]

Terms Used In Maine Revised Statutes Title 24-A Sec. 6608

  • arrangement: means an employer welfare benefit plan or any other arrangement that is established or maintained for the purpose of offering or providing health benefits to the employees of 2 or more employers or to their beneficiaries. See Maine Revised Statutes Title 24-A Sec. 6601
  • Contract: A legal written agreement that becomes binding when signed.
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Participation agreement: means the document pursuant to which an employer undertakes and agrees to fulfill the obligation of employers imposed by the declaration of trust. See Maine Revised Statutes Title 24-A Sec. 6601
2. Grounds for disapproval of forms by superintendent. The superintendent may disapprove a form filed under this section or withdraw previous approval of a form only if the form:
A. Violates or does not comply with this chapter; [PL 1993, c. 688, §1 (NEW).]
B. Contains or incorporates by reference inconsistent, ambiguous or misleading clauses or exceptions and conditions that deceptively affect the risk proposed to be assumed in the general coverage of the contract; [PL 1993, c. 688, §1 (NEW).]
C. Has any title, heading or other indication of its provisions that is misleading; [PL 1993, c. 688, §1 (NEW).]
D. Is printed or otherwise reproduced in such manner as to render any material provision of the form substantially illegible; or [PL 1993, c. 688, §1 (NEW).]
E. Contains provisions that are unfair, inequitable or encourage misrepresentation. [PL 1993, c. 688, §1 (NEW).]

[PL 1993, c. 688, §1 (NEW).]

SECTION HISTORY

PL 1993, c. 688, §1 (NEW).