For purposes of
this section, the following definitions apply:
1. "Captive" means a captive insurance
company licensed pursuant to Title 24-A M.R.S.A. Chapter 83.
2. "MEWA" means a multiple-employer welfare
arrangement licensed pursuant to Title 24-A M.R.S.A. Chapter 81.
When a rate increase has been
identified as "potentially unreasonable" in accordance with the ACA, the
following provisions of this Rule apply to MEWAs and captives:
, General Rate Submission
, Small Group Health Plans, applies
with respect to coverage of small employers, except that Subsection E does not
apply and Subsection D applies regardless of whether the average number of
members covered meets credibility standards pursuant to the ACA.
, Review Pursuant to the ACA,
, Policies Subject to the ACA
Rating Requirements, applies.
Notwithstanding the requirement for separate large group and small group
filings in Sections
, a MEWA or captive may make a
combined large and small group rate filing if the rates do not differ between
large and small groups. However, separate ACA Preliminary Justifications must
be included for small groups and, if required, for large groups.
C. When a rate increase is subject
to the ACA and has not been identified as "potentially unreasonable" in
accordance with the ACA, the MEWA or captive shall provide an informational
filing at least 60 days before the effective date of the rate increase
explaining why the increase is not "potentially unreasonable" as defined under
, Rebates and Medical Loss Ratio
Reporting, applies to MEWAs and captives to the extent required by the
E. Notwithstanding Paragraph
5(C)(6), MEWAs and captives may prepare filings in a manner that protects the
confidentiality of information that is confidential under Maine law, including
in the case of captives any information that is protected by Title 24-A
M.R.S.A. § 6715, by following the confidentiality protocol available on
the Bureau of Insurance web site.
No other provisions of this rule apply to
MEWAs and captives, except that the general provisions set forth in Sections
apply to the extent relevant.