§ 24-A §6603 — General eligibility

Maine § 24-A §6603

• Jurisdiction: Maine
• Title 24-A: MAINE INSURANCE CODE
• Ch. 81: MULTIPLE-EMPLOYER WELFARE ARRANGEMENTS

Text

This section governs all multiple-employer welfare arrangements except for those offered by a registered employee leasing company complying with the requirements of section 6603‑A.
1.
Requirements for approval.
To meet the requirements for approval and to maintain a multiple-employer welfare arrangement, an arrangement:
1-A.
Eligibility based on geographic association.
2.
Evidence of benefits; issuance to covered employee.
The arrangement shall issue to each covered employee a contract, certificate, summary plan description or other evidence of the benefits and coverages provided. This evidence of the benefits and coverages provided must contain in boldface print in a conspicuous location the following statement: "The benefits and coverages described herein are provided through a trust fund established and funded by a group of employers." Arrangements in existence before October 1, 1993 that have previously issued benefit descriptions to employees may meet the disclosure requirements under this chapter by issuing to each employee additional written material necessary to meet the requirements of this subsection.
3.
Maintenance of specific excess insurance.
Each arrangement shall maintain specific excess insurance with a retention level determined in accordance with sound actuarial principles and approved by the superintendent. The superintendent may also require the arrangement to purchase aggregate excess insurance.
4.
Maintenance of appropriate loss reserves.
Each arrangement shall establish and maintain appropriate loss and loss expense reserves determined in accordance with sound actuarial principles and shall fund obligations by depositing assets that will yield in a time frame matching maturing liabilities of the arrangement sufficient funds to discharge claims and other expense payments.
5.
Funds held in trust.
All funds of a multiple-employer welfare arrangement must be held in trust in this State in the name of the arrangement in a qualified financial institution by state or federally chartered financial institutions until such time as they are disbursed.
6.
Replacement of trustee.
The superintendent may not grant or continue approval until the arrangement replaces any trustee found by the superintendent:
7.
Contracts available for inspection.
To qualify for and retain approval to transact business, an arrangement must make all contracts with administrators or service companies available for inspection by the bureau initially and thereafter upon reasonable notice.
8.
Suspension or revocation of approval.
Failure to maintain compliance with applicable eligibility or filing requirements established by this section is grounds for suspension or revocation of authority of an arrangement. However, with respect to deficiencies other than an impairment, the arrangement has 60 days after notification by the superintendent to take action necessary to correct the deficiency.
9.
Access to health care services.

Legislative History

PL 1993, c. 688, §1 (NEW). PL 1995, c. 618, §6 (AMD). PL 1999, c. 256, §R1 (AMD). PL 2001, c. 410, §A9 (AMD). PL 2001, c. 570, §1 (AMD). PL 2001, c. 570, §2 (AMD). PL 2003, c. 374, §§1,2 (AMD). PL 2005, c. 121, §A1 (AMD). PL 2007, c. 278, §1 (AMD). PL 2011, c. 90, Pt. F, §8 (AMD). PL 2019, c. 96, §§2, 3 (AMD).