Maine Revised Statutes Title 24-A Sec. 5054 – Certification by superintendent
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1. Filing of form. Any insurer, nonprofit hospital or medical service organization, or nonprofit health care plan may, at the time it files a policy or contract for approval for issuance or delivery in the State, or at any time thereafter, request that the superintendent certify the policy or contract as a long-term care policy within the meaning of section 5051.
Within 60 days of receipt of a request for certification, the superintendent shall:
A. Certify in writing that the policy or contract complies with this section; [PL 1989, c. 556, Pt. B, §4 (NEW).]
B. Deny the request in writing, stating the reasons for denial; or [PL 1989, c. 556, Pt. B, §4 (NEW).]
C. Notify the insurer or nonprofit hospital or medical service organization or nonprofit health care plan, in writing, that an insufficient basis exists for determining whether a certification should be made, indicating in what respects the request was insufficient. [PL 1997, c. 604, Pt. D, §6 (AMD).]
[PL 1997, c. 604, Pt. D, §6 (AMD).]
Terms Used In Maine Revised Statutes Title 24-A Sec. 5054
- Contract: A legal written agreement that becomes binding when signed.
- in writing: include printing and other modes of making legible words. See Maine Revised Statutes Title 1 Sec. 72
- Long-term care policy: means a group or individual policy of health insurance, a subscriber contract of a nonprofit hospital or medical service organization or nonprofit health care plan or a life insurance rider which is advertised, marketed or designed primarily to provide coverage for not less than 12 consecutive months for each covered person on an expense-incurred basis, indemnity basis, prepaid or other basis for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance or personal care services, provided in a setting other than an acute care unit of a hospital. See Maine Revised Statutes Title 24-A Sec. 5051
2. Standards for compliance. The superintendent shall certify a policy or contract submitted for review under this section as a long-term care policy if the superintendent finds that the policy or contract:
A. Is a long-term care policy within the meaning of section 5051; and [PL 1989, c. 556, Pt. B, §4 (NEW).]
B. Complies with all standards applicable to long-term care policies as set forth in this chapter and in chapters 27, 33 and 35 and in rules adopted pursuant to any of those chapters by the superintendent. Waivers granted under the rules shall be taken into consideration. [PL 1989, c. 556, Pt. B, §4 (NEW).]
[PL 1989, c. 556, Pt. B, §4 (NEW).]
SECTION HISTORY
PL 1989, c. 556, §B4 (NEW). PL 1997, c. 604, §D6 (AMD).