Code of Maine Rules
02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
031 - BUREAU OF INSURANCE
Chapter 320 - MINIMUM STANDARDS FOR ALCOHOLISM AND DRUG DEPENDENCY BENEFITS
Section 031-320-7 - Major medical policy

This section applies only to policies that are subject to this rule but are not subject to the parity requirements of Title 24-A M.R.S.A., Section2843(5-C). Most policies subject to this rule will be subject to the parity requirements and not to this section. The exception is group policies other than employee groups, such as association groups, to the extent they cover employees of employers with 20 or fewer employees. Any supplemental major medical Policy subject to this section will be deemed to be in compliance with the requirements of Title 24-A M.R.S.A., Section2842 if it provides, at a minimum, the benefits provided under Section 5 above less an amount equal to the covered charges used to determine the benefit provided by any base coverage provided the same group, by an insurer or non-profit and/or hospital medical services organization. Although a supplemental major medical policy must contain the minimum required benefits, it is the intent of the Rule that a person covered under both base coverage and a supplemental major medical policy not be entitled to "stack" the substance abuse benefits of the two policies. The two policies combined need not provide, in the aggregate, more than the minimum required benefits.