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 031-851-6 - Alternative Plan Designs
Universal Citation: 02 ME Code Rules ยง 031-851-6
Current through 2024-38, September 18, 2024
1. A carrier may request approval, in accordance with this section, to offer up to three Alternative Plan Designs in any plan year.
2. The carrier's application shall be submitted no later than the deadline announced by the Superintendent for rate and form filings, and shall include:
A. An
actuarial certification, including an explanation why the Alternative Plan
Design is not expected to promote adverse selection, a description of the
significant consumer benefits that are anticipated, and an explanation why
those benefits are not available from any Clear Choice Design or from any of
the carrier's other Alternative Plan Designs;
B. Copies of all policy forms the carrier
proposes to use in conformance with the Alternative Plan Design, and if there
are multiple forms, optional endorsements, or variable language, an explanation
why the variations should not be considered distinct plan designs for purposes
of this rule; and
C. If the carrier
is proposing to modify or discontinue an Alternative Plan Design already in
use, an explanation why the modification or discontinuance is permitted under
24-A M.R.S. §2850- B(3)(G) or (I), including a proposed mapping for
existing policyholders.
3. If an Alternative Plan Design is approved, the carrier may only offer it in service areas where the carrier offers at least one Clear Choice Plan in the same metal tier.
Disclaimer: These regulations may not be the most recent version. Maine may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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