Part A – Maximum Rate Differential
This section of the bill will increase the amount an insurer can charge a customer based on certain criteria, such as geography. The current maximum rate differential is 1:1.5, and this bill will increase it to 1:5, phasing it in over a few years.
Part B – High-risk Pool
This section eliminates the guaranteed issue, which states that insurance companies can not reject issuing a policy for any reason, and would establish a high-risk pool for the insured. It would levy a $4/per-month-per-person tax to fund a pool of money that would aim to cover those that are deemed “uninsurable” for reason of chronic illness or pre-existing conditions, such as cancer.
Part C – Out-of-state Insurance
This section would allow the purchasing of health insurance from Massachusetts, Rhode Island, Connecticut and New Hampshire. Vermont has presumably been left out because they are adopting a single-payer health insurance system. If the State of Maine can come to a Memorandum of Understanding with one of these states, it would allow each state to purchase policies from the other.
Part D – Medical Loss Ratio
This section requires on how much insurance companies must spend on medical care rather than administration, marketing and advertising. In this bill Maine changes from X to X.
Part E – Repeal of Maine State Health Insurance
This section would repeal assistance for those with or soon expecting Medicare. Trained health insurance counselors are available throughout Maine to provide you with information about Medicare and other health insurance issues.
Part F – Repeal of Geographic Access Standards
This section repeals a provison known as the Geographic Access Standards. These standards say that an insurance company cannot require a patient to travel more than a certain distance for medical care. If this section passes, it means an insurance company could require a Fort Kent resident to travel to Portland for care.
Part H – Wellness Tax Credit
This section establishes a tax credit for businesses to establish wellness programs for their employees. It allows $100 per employee, up to $2,000 dollars per business per year.
Part I – Captives Insurance
This allows companies to bundle together to create a vehicle to self-insure. The captive must have the same solvency as insurance companies. Additionally, captives must have the state’s same community rating and guaranteed issue as similar health insurances.
Part J – Elimination of Office of Health Management
This section eliminates the Governor’s Office of Health Policy and Finance and all references of it in state statute.
Part K – Financials
This section describes the financial aspects of the bill.
