Maine § 24-A §2803-A Loss information

Maine Statutes

§ 24-A §2803-A — Loss information

Maine·Title 24-A MAINE INSURANCE CODE·Ch. 35 GROUP AND BLANKET HEALTH INSURANCE

1.Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings.

2.Disclosure of basic loss information. Upon written request, every insurer shall provide loss information, in accordance with the minimum requirements of paragraph A, concerning a group policy or contract to its policyholder, to a former policyholder or to a school administrative unit pursuant to Title 20‑A, section 1001, subsection 14, paragraph E within 21 business days of the date of the request. This subsection does not apply to a former policyholder whose coverage terminated more than 18 months prior to the date of a request. For the purposes of this subsection, "school administrative unit" has the same meaning as in Title 20‑A, section 1, subsection 26.

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1.
Definitions.
As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
2.
Disclosure of basic loss information.
Upon written request, every insurer shall provide loss information, in accordance with the minimum requirements of paragraph A, concerning a group policy or contract to its policyholder, to a former policyholder or to a school administrative unit pursuant to Title 20‑A, section 1001, subsection 14, paragraph E within 21 business days of the date of the request. This subsection does not apply to a former policyholder whose coverage terminated more than 18 months prior to the date of a request. For the purposes of this subsection, "school administrative unit" has the same meaning as in Title 20‑A, section 1, subsection 26.
3.
Transmittal of request.
An insurance contractor or producer who receives a request for loss information in accordance with this section shall transmit the request for loss information to the insurer within 4 business days. An insurer receiving a disclosure request under subsection 2 may transmit high-cost claimant data directly to another insurer or underwriter, or to a contractor or producer that has signed with that insurer a business associate agreement that is in accordance with 45 Code of Federal Regulations, Sections 164.502(e) and 164.504(e), for the purpose of securing quotes, developing actuarial reports, facilitating claim management or other activities related to quoting or managing the group health plan sponsored by the requesting group policyholder.
4.
Exception.
An insurer is not required to provide the loss information described in this section for a group that is eligible for small group coverage pursuant to section 2808‑B.

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Legislative History

PL 1995, c. 71, §2 (NEW). PL 1997, c. 370, §E5 (AMD). PL 2001, c. 410, §§B1,2 (AMD). PL 2003, c. 428, §D1 (AMD). RR 2011, c. 1, §39 (COR). PL 2011, c. 395, §4 (AMD). PL 2015, c. 420, §2 (AMD). PL 2023, c. 297, §1 (AMD).