02-031 C.M.R. ch. 130, § 3 - Scope

The standards set forth in Sections 4 through 8 and the Appendices apply to all claims incurred before January 1, 2020 under individual and group health insurance coverages issued by insurance companies doing business in this State, except as provided in this section.

A. Claims incurred on and after January 1, 2020, shall be valued in accordance with the applicable standards as specified in Valuation Manual as adopted in accordance with 24-A M.R.S.A. §959, including guidance applicable to coverage issued before 2020 as set forth in the NAIC Accounting Practices and Procedures Manual, or its successor publication, as adopted in accordance with 24-A M.R.S.A. §901-A(1)(A).

B. Open claims incurred before January 1, 2020 may, at the option of the insurer, be valued in accordance with applicable standards as specified in the Valuation Manual, including any applicable adjustments, modifications, or exceptions, provided that the election is made consistently for all open claims.

C. Once an insurer has exercised an option to value previously-incurred claims on the basis of a more recent valuation standard, all future valuations of those claims must be made on the same basis, applied consistently to all open claims, unless and until the insurer updates to a still more recent standard.

Notes

02-031 C.M.R. ch. 130, § 3