Code of Maine Rules
02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
031 - BUREAU OF INSURANCE
Chapter 851 - Clear Choice Designs for Individual and Small Group Health Plans
Section 031-851-3 - Definitions
Current through 2024-38, September 18, 2024
The following definitions apply for purposes of this rule:
1. "Affordable Care Act" or "ACA" has the same meaning as in 24-A M.R.S. §14.
2. "Actuarial value" or "AV" means the anticipated covered medical spending paid by a health plan for a standard population for essential health benefit coverage, as defined in 24-A M.R.S. §4320- D(2), computed in accordance with the plan's cost sharing, and divided by the total anticipated allowed charges for essential health benefit coverage provided to a standard population, using the most recent AV calculator published by CMS and any adjustments made by the carrier.
3. "Carrier" has the same meaning as in 24-A M.R.S. §4301- A(3).
4. "HSA plan" means a health plan that is intended to qualify as a high deductible health plan under the federal Internal Revenue Code for purposes of eligibility to maintain a tax-exempt Health Savings Account.
5. "Marketplace" means the Maine Health Insurance Marketplace established pursuant to 22 M.R.S. §5403.
6. "Pooled market implementation year" means the implementation year established by the Superintendent pursuant to Chapter 856 of these rules, "Combination of the Individual and Small Business Health Insurance Risk Pools."
