Maine 125 - HP 1140 - An Act To Implement the Requirements of the Federal Patient Protection and Affordable Care Act

Sep 19, 2026

125th Maine Legislature first regular session legislative document HP 1140 (House of Representatives, May 5, 2011) titled “An Act To Implement the Requirements of the Federal Patient Protection and Affordable Care Act.” Submitted by the Department of Professional and Financial Regulation, it amends Maine insurance statutes regarding definitions, premium rate variations related to tobacco use and smoking status, risk pool treatment for enrollees, and exemptions for certain associations, with effective timing keyed to January 1, 2014.

LanguageEnglish

CategoryForms

FormatPDF

Pages16

Reading Time6 min

AccessFree to download

Legislative Document Overview

Amendments to 24-A MRSA Provisions

Premium Rate and Risk Pool Rules

Association Exemptions

125th MAINE LEGISLATURE FIRST REGULAR SESSION-2011 | Legislative Document No. 1554 | | --- | | H.P. 1140 House of Representatives, May 5, 2011
An Act To Implement the Requirements of the Federal Patient
Protection and Affordable Care Act | Submitted by the Department of Professional and Financial Regulation pursuant to Joint Rule 204. Reference to the Committee on Insurance and Financial Services suggested and ordered printed. HEATHER J.R. PRIEST Clerk Presented by Representative RICHARDSON of Warren. Printed on recycled paper 1 Be it enacted by the People of the State of Maine as follows: 2 Sec. 1. 24-A MRSA §14 is enacted to read: 3 §14. "Affordable Care Act" defined 4 "Affordable Care Act" means the federal Patient Protection and Affordable Care Act, 5 Public Law 111-148, adopted March 23, 2010, as amended by the federal Health Care 6 and Education Reconciliation Act of 2010, Public Law 111-152, and federal regulations 7 adopted pursuant to that Act. 8 Sec. 2. 24-A MRSA §2736-C, sub-§2, ¶C, as amended by PL 2001, c. 410, Pt. 9 A, §1 and affected by §10, is further amended to read: 10 C. ~~A~~ For all policies, contracts or certificates that are executed, delivered, issued for 11 delivery, continued or renewed in this State before January 1, 2014, a carrier may 12 vary the premium rate due to smoking status and family membership. The 13 superintendent may adopt rules setting forth appropriate methodologies regarding rate 14 discounts based on smoking status. Rules adopted pursuant to this paragraph are 15 routine technical rules as defined in Title 5, chapter 375 , subchapter ~~II-A~~ 2-A. 16 Sec. 3. 24-A MRSA §2736-C, sub-§2, ¶C-1 is enacted to read: 17 C-1. For all policies, contracts or certificates that are executed, delivered, issued for 18 delivery, continued or renewed in this State on or after January 1, 2014, a carrier may 19 vary the premium rate due to tobacco use and family membership. Variations due to 20 tobacco use may not exceed a ratio of 1.5 to 1. 21 Sec. 4. 24-A MRSA §2736-C, sub-§2, ¶I is enacted to read: 22 I. Except for grandfathered health plans under the Affordable Care Act, a carrier 23 shall consider all enrollees in all individual health plans offered by the carrier to be 24 members ofa single risk pool to the extent required by the Affordable Care Act. 25 Sec. 5. 24-A MRSA §2736-C, sub-§9, as enacted by PL 1995, c. 570, §7, is 26 amended to read: 27 9. Exemption for certain associations. The superintendent may exempt a group 28 health insurance policy or group nonprofit hospital or medical service corporation 29 contract issued to an association group, organized pursuant to section 2805-A, from the 30 requirements of subsection 3, paragraph A; subsection 6, paragraph A; and subsection 8 31 if: 32 A. Issuance and renewal of coverage under the policy or contract is guaranteed to all 33 members of the association who are residents of this State and to their dependents; 34 B. Rates for the association comply with the premium rate requirements of 35 subsection 2 or are established on a nationwide basis and substantially comply with 36 the purposes of this section, except that exempted associations may be rated 37 separately from the carrier's other individual health plans, if any; 1 C. The group's anticipated loss ratio, as defined in subsection 5, is at least 75%; 2 D. The association's membership criteria do not include age, health status, medical 3 utilization history or any other factor with a similar purpose or effect; 4 E. The association's group health plan is not marketed to the general public; 5 F. The association does not allow insurance agents or brokers to market association 6 memberships, accept applications for memberships or enroll members, except when 7 the association is an association of insurance agents or brokers organized under 8 section 2805-A; 9 G. Insurance is

FAQs

What legislation does HP 1140 seek to implement?

HP 1140 implements requirements of the Federal Patient Protection and Affordable Care Act (Affordable Care Act).

How does the act address premium rate variation related to tobacco use?

For policies executed, delivered, issued, continued, or renewed on or after January 1, 2014, a carrier may vary premiums due to tobacco use and family membership, with tobacco-related variations limited to a ratio of 1.5 to 1.

What is the rule for treating enrollees for risk pool purposes?

Except for grandfathered health plans, the carrier must consider all enrollees in all individual health plans offered by the carrier as members of a single risk pool as required by the Affordable Care Act.

Sep 19, 2026

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