Maine Revised Statutes Title 24-A Sec. 4227 – Choice of alternative coverage
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Terms Used In Maine Revised Statutes Title 24-A Sec. 4227
- Health care services: means any services included in the furnishing of medical care, dental care or hospitalization to an individual, or any services incident to the furnishing of that care or hospitalization, as well as the furnishing of any other services to an individual to prevent, alleviate, cure or heal human illness or injury. See Maine Revised Statutes Title 24-A Sec. 4202-A
- Health maintenance organization: means a public or private organization that is organized under the laws of the Federal Government, this State, another state or the District of Columbia or a component of such an organization, and that:
A. See Maine Revised Statutes Title 24-A Sec. 4202-APoint-of-service option: means a health maintenance organization product that allows an enrollee to select either the comprehensive health care benefits of the health maintenance organization or care from a provider of the enrollee's choice outside the health maintenance organization network with traditional indemnity benefits. See Maine Revised Statutes Title 24-A Sec. 4202-A
Any employer of more than 50 employees who offers a health maintenance organization, as defined in section 4202?A, shall also offer its employees, at the time of offering and renewal of the health maintenance organization, the option of selecting alternative health benefits coverage that does not restrict the ability of the covered persons to obtain health care services from the providers of their choice. [PL 1991, c. 709, §8 (AMD).]
Any employer subject to this section shall contribute to the alternative health benefits coverage to the same extent as it contributes to the health maintenance organization. [PL 1985, c. 704, §8 (NEW).]
An employer may not be required to pay more for health benefits as a result of the application of this section than would otherwise be paid. [PL 1991, c. 709, §8 (AMD).]
An employer may satisfy the requirements of this section by offering a point-of-service option but may not satisfy the requirements of this section by contributing to the cost of an individual health plan. [PL 1997, c. 370, Pt. B, §4 (AMD).]
SECTION HISTORY
PL 1985, c. 704, §8 (NEW). PL 1991, c. 709, §8 (AMD). PL 1997, c. 370, §B4 (AMD).