Maine § 24-A §4334 Substantial insurance risk; substantial enrollment risk

Maine Statutes

§ 24-A §4334 — Substantial insurance risk; substantial enrollment risk

Maine § 24-A §4334

Title 24-AMAINE INSURANCE CODE

Ch. 56-AHEALTH PLAN IMPROVEMENT ACT

This text of Maine § 24-A §4334 (Substantial insurance risk; substantial enrollment risk) is published on Counsel Stack Legal Research, covering Maine primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Me. Rev. Stat. tit. 24-A, § 24-A §4334 (2026).

Text

1.Substantial insurance risk. Substantial insurance risk is risk based on the use or costs of referral services only, when the downstream entity is at risk for more than 25% of potential payments by the carrier to the downstream entity.

2.Substantial enrollment risk. Substantial enrollment risk exists when a carrier enters into a risk arrangement with a downstream entity involving more than 25% of the enrollees served by the carrier in the State unless the risk arrangement is a risk-sharing arrangement.

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1.
Substantial insurance risk.
Substantial insurance risk is risk based on the use or costs of referral services only, when the downstream entity is at risk for more than 25% of potential payments by the carrier to the downstream entity.
2.
Substantial enrollment risk.
Substantial enrollment risk exists when a carrier enters into a risk arrangement with a downstream entity involving more than 25% of the enrollees served by the carrier in the State unless the risk arrangement is a risk-sharing arrangement.