Me. Rev. Stat. tit. 24-A, ch. 35 – Group and Blanket Health Insurance | Midpage

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Maine Revised Statutes

Chapter 35

Me. Rev. Stat. tit. 24-A, ch. 35

Group and Blanket Health Insurance

2801Scope of chapter -- short title 2802Group insurance defined 2803Requirements 2803-ALoss information 2804Employee groups 2804-APrivate purchasing alliances 2804-BGroup disability income protection plan 2805Labor union groups 2805-AAssociation groups 2806Trustee groups 2807Debtor groups 2807-ACredit union groups 2808Other groups 2808-BSmall group health plans 2809Coverage of family, dependents; continuation of coverage 2809-AConversion on termination of policy or eligibility 2810Group health insurance payments; beneficiaries 2811Payment of expenses 2812-ADividends and experience refunds 2813"Blanket health insurance" defined 2814Blanket health insurance; payments; beneficiaries 2815Legal liability of policyholders 2816Requirements 2817Applicant's statements; waivers, amendments 2818Statements in application 2819New employees, members 2820Renewal of policy 2821Individual certificates 2822Age limits 2823Notice of claim 2823-AExplanation and notice to parent 2823-BStandardized claim forms 2824Proof of loss 2825Forms for proof of loss 2826Examination, autopsy 2827Time for payment of benefits 2827-AAssignment of benefits 2828Time for suits 2829Exceptions 2829-ADisability benefit offsets 2830Omissions, modifications: superintendent may approve 2831Hospital, medical benefits; direct payment 2832Maternity benefits for unmarried women certificate holders and the minor dependents of certificate holders with dependent or family coverage required 2832-AMandated offer of domestic partner benefits 2833Child coverage 2833-AExtension of coverage for dependent children 2833-BMandatory offer to extend coverage for dependent children up to 26 years of age 2833-CMandatory offer of coverage for certain adults with disabilities 2834Newborn children coverage 2834-AMaternity and routine newborn care 2834-BDependent special enrollment period 2834-CCompliance with federal law 2834-DMaternity and postpartum care 2835Mental health services 2836Limits on priority liens 2837Home health care coverage 2837-ACoverage for screening mammograms and diagnostic and supplemental breast examinations 2837-BAcupuncture services 2837-CCoverage for breast cancer treatment 2837-DMedical food coverage for inborn error of metabolism 2837-ECoverage for Pap tests 2837-FOff-label use of prescription drugs for cancer 2837-GOff-label use of prescription drugs for HIV or AIDS 2839Rates filed 2839-ANotice of rate increase 2839-BLarge group rates 2840-ACoverage for chiropractic services 2841Optional coverage for optometric services 2842Equitable health care for substance use disorder treatment 2843Mental health services coverage 2844Coordination of benefits 2845Cardiac rehabilitation coverage 2846Acquired Immune Deficiency Syndrome 2847Utilization review data 2847-APenalty for failure to notify of hospitalization 2847-BJury service 2847-CNotification prior to cancellation; restrictions on cancellation, termination or lapse due to cognitive impairment or functional incapacity 2847-DPenalty for noncompliance with utilization review programs 2847-ECoverage for diabetes supplies 2847-GCoverage for contraceptives 2847-JCoverage for hospice care services 2847-LOffer of coverage for breast reduction surgery and symptomatic varicose vein surgery 2847-MEnrollment for individuals or families establishing eligibility for MaineCare 2847-NCoverage for colorectal cancer screening 2847-QCoverage for services provided by independent practice dental hygienist or dental hygienist 2847-REnrollment of dependent children in dental coverage 2847-UCoverage for services provided by dental therapist 2847-VAbsolute discretion clauses 2847-WDental benefit waiting period 2847-XFees for covered dental services