§ 2801 Scope of chapter — short title
§ 2802 Group insurance defined
§ 2803 Requirements
§ 2803-A Loss information
§ 2804 Employee groups
§ 2804-A Private purchasing alliances
§ 2804-B Group disability income protection plan
§ 2805 Labor union groups
§ 2805-A Association groups
§ 2806 Trustee groups
§ 2807 Debtor groups
§ 2807-A Credit union groups
§ 2808 Other groups
§ 2808-B Small group health plans
§ 2809 Coverage of family, dependents; continuation of coverage
§ 2809-A Conversion on termination of policy or eligibility
§ 2810 Group health insurance payments; beneficiaries
§ 2811 Payment of expenses
§ 2812-A Dividends and experience refunds
§ 2813 “Blanket health insurance” defined
§ 2814 Blanket health insurance; payments; beneficiaries
§ 2815 Legal liability of policyholders
§ 2816 Requirements
§ 2817 Applicant’s statements; waivers, amendments
§ 2818 Statements in application
§ 2819 New employees, members
§ 2820 Renewal of policy
§ 2821 Individual certificates
§ 2822 Age limits
§ 2823 Notice of claim
§ 2823-A Explanation and notice to parent
§ 2823-B Standardized claim forms
§ 2824 Proof of loss
§ 2825 Forms for proof of loss
§ 2826 Examination, autopsy
§ 2827 Time for payment of benefits
§ 2827-A Assignment of benefits
§ 2828 Time for suits
§ 2829 Exceptions
§ 2829-A Disability benefit offsets
§ 2830 Omissions, modifications: superintendent may approve
§ 2831 Hospital, medical benefits; direct payment
§ 2832 Maternity benefits for unmarried women certificate holders and the minor dependents of certificate holders with dependent or family coverage required
§ 2832-A Mandated offer of domestic partner benefits
§ 2833 Child coverage
§ 2833-A Extension of coverage for dependent children
§ 2833-B Mandatory offer to extend coverage for dependent children up to 26 years of age
§ 2833-C Mandatory offer of coverage for certain adults with disabilities
§ 2834 Newborn children coverage
§ 2834-A Maternity and routine newborn care
§ 2834-B Dependent special enrollment period
§ 2834-C Compliance with federal law
§ 2834-D Maternity and postpartum care
§ 2835 Mental health services
§ 2836 Limits on priority liens
§ 2837 Home health care coverage
§ 2837-A Coverage for screening mammograms and diagnostic and supplemental breast examinations
§ 2837-B Acupuncture services
§ 2837-C Coverage for breast cancer treatment
§ 2837-D Medical food coverage for inborn error of metabolism
§ 2837-E Coverage for Pap tests
§ 2837-F Off-label use of prescription drugs for cancer
§ 2837-G Off-label use of prescription drugs for HIV or AIDS
§ 2837-H Coverage for prostate cancer screening
§ 2839 Rates filed
§ 2839-A Notice of rate increase
§ 2839-B Large group rates
§ 2840 Optional coverage for chiropractic services
§ 2840-A Coverage for chiropractic services
§ 2841 Optional coverage for optometric services
§ 2842 Equitable health care for substance use disorder treatment
§ 2843 Mental health services coverage
§ 2844 Coordination of benefits
§ 2845 Cardiac rehabilitation coverage
§ 2846 Acquired Immune Deficiency Syndrome
§ 2847 Utilization review data
§ 2847-A Penalty for failure to notify of hospitalization
§ 2847-B Jury service
§ 2847-C Notification prior to cancellation; restrictions on cancellation, termination or lapse due to cognitive impairment or functional incapacity
§ 2847-D Penalty for noncompliance with utilization review programs
§ 2847-E Coverage for diabetes supplies
§ 2847-F Gynecological and obstetrical services
§ 2847-G Coverage for contraceptives
§ 2847-H Coverage for services of certified nurse practitioners; certified midwives; certified nurse midwives
§ 2847-I Coverage for services provided by registered nurse first assistants
§ 2847-J Coverage for hospice care services
§ 2847-K Coverage for general anesthesia for dentistry
§ 2847-L Offer of coverage for breast reduction surgery and symptomatic varicose vein surgery
§ 2847-M Enrollment for individuals or families establishing eligibility for MaineCare
§ 2847-N Coverage for colorectal cancer screening
§ 2847-O Coverage for hearing aids
§ 2847-P Coverage for medically necessary infant formula
§ 2847-Q Coverage for services provided by independent practice dental hygienist
§ 2847-R Enrollment of dependent children in dental coverage
§ 2847-S Coverage for children’s early intervention services
§ 2847-T Coverage for the diagnosis and treatment of autism spectrum disorders
§ 2847-U Coverage for services provided by dental therapist
§ 2847-V Absolute discretion clauses
§ 2847-W Dental benefit waiting period

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Terms Used In Maine Revised Statutes > Title 24-A > Chapter 35 - Group and Blanket Health Insurance

  • Advice and consent: Under the Constitution, presidential nominations for executive and judicial posts take effect only when confirmed by the Senate, and international treaties become effective only when the Senate approves them by a two-thirds vote.
  • Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
  • Agent: means an individual:
A. See Maine Revised Statutes Title 22 Sec. 2942
  • Anatomical gift: means a donation of all or part of a human body to take effect after the donor's death for the purposes of transplantation, therapy, research or education. See Maine Revised Statutes Title 22 Sec. 2942
  • Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
  • Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
  • Arrest: Taking physical custody of a person by lawful authority.
  • Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
  • Bail: Security given for the release of a criminal defendant or witness from legal custody (usually in the form of money) to secure his/her appearance on the day and time appointed.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Charitable purpose: means the relief of poverty, the advancement of education or religion, the promotion of health, the promotion of a governmental purpose or any other purpose the achievement of which is beneficial to the community. See Maine Revised Statutes Title 13 Sec. 5102
  • Chief Medical Examiner: means the Office of Chief Medical Examiner within the Office of the Attorney General. See Maine Revised Statutes Title 22 Sec. 2942
  • Child or children: means a person who has not attained the age of 18 years. See Maine Revised Statutes Title 1 Sec. 72
  • Commissioner: means the Commissioner of Health and Human Services. See Maine Revised Statutes Title 22 Sec. 1-A
  • Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Counterclaim: A claim that a defendant makes against a plaintiff.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Decedent: includes a stillborn infant and, subject to restrictions imposed by law other than this chapter, a fetus. See Maine Revised Statutes Title 22 Sec. 2942
  • Dependent: A person dependent for support upon another.
  • Disinterested witness: means a witness other than the spouse, domestic partner, child, parent, sibling, grandchild, grandparent or guardian of the individual who makes, amends, revokes or refuses to make an anatomical gift, or another adult who exhibited special care and concern for the individual and who is familiar with the individual's personal values. See Maine Revised Statutes Title 22 Sec. 2942
  • Document of gift: means a donor card, advance directive or other record used to make an anatomical gift. See Maine Revised Statutes Title 22 Sec. 2942
  • Donor: means an individual whose body or part is the subject of an anatomical gift. See Maine Revised Statutes Title 22 Sec. 2942
  • Donor: The person who makes a gift.
  • Donor registry: means the Maine Organ Donor Registry maintained under Title 29?A, section 1402?A as well as any other electronic database that identifies donors and complies with section 2958. See Maine Revised Statutes Title 22 Sec. 2942
  • Endowment fund: means an institutional fund or part thereof that, under the terms of a gift instrument, is not wholly expendable by the institution on a current basis. See Maine Revised Statutes Title 13 Sec. 5102
  • Engineered disposal system: means a subsurface wastewater disposal system designed, installed and operated as a single unit to treat and dispose of at least 2,000 gallons of wastewater per day or a system designed to be capable of treating wastewater with significantly high 5-day biochemical oxygen demand and total suspended solid concentrations. See Maine Revised Statutes Title 12 Sec. 4807
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Existing dam: means any human-made barrier across a river segment identified in this chapter that impounds water and has not deteriorated or been breached or modified to the point where it no longer impounds water at 50% or more of its design level at normal flows. See Maine Revised Statutes Title 12 Sec. 403-A
  • Eye bank: means a person that is licensed, accredited or regulated under federal or state law to engage in the recovery, screening, testing, processing, storage or distribution of human eyes or portions of human eyes. See Maine Revised Statutes Title 22 Sec. 2942
  • Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
  • federal Affordable Care Act: means the federal Patient Protection and Affordable Care Act, Public Law 111-148, as amended by the federal Health Care and Education Reconciliation Act of 2010, Public Law 111-152, and any amendments to or regulations or guidance issued under those acts. See Maine Revised Statutes Title 24-A Sec. 14
  • Fee simple: Absolute title to property with no limitations or restrictions regarding the person who may inherit it.
  • First-time subsurface waste disposal system: means the first subsurface waste disposal system designed to serve a specific structure. See Maine Revised Statutes Title 12 Sec. 4807
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • Gift instrument: means a record or records, including an institutional solicitation, under which property is granted to, transferred to or held by an institution as an institutional fund. See Maine Revised Statutes Title 13 Sec. 5102
  • Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. Source: Federal Reserve
  • Guardian: means a person appointed by a court to make decisions regarding the support, care, education, health and welfare of an individual. See Maine Revised Statutes Title 22 Sec. 2942
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Historic dollar value: means the aggregate value in dollars of:
  • A. See Maine Revised Statutes Title 13 Sec. 5102
  • Hospital: means a facility licensed as a hospital under chapter 405 or the law of any state or a facility operated as a hospital by the United States, a state or a subdivision of a state. See Maine Revised Statutes Title 22 Sec. 2942
  • Identification card: means a nondriver identification card issued by the Secretary of State under Title 29?A, section 1410. See Maine Revised Statutes Title 22 Sec. 2942
  • Infant: means a person who has not attained the age of 18 years. See Maine Revised Statutes Title 1 Sec. 72
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Institution: means :
  • A. See Maine Revised Statutes Title 13 Sec. 5102
  • Institutional fund: means a fund held by an institution exclusively for charitable purposes. See Maine Revised Statutes Title 13 Sec. 5102
  • Inter vivos: Transfer of property from one living person to another living person.
  • intertidal land: means all land of this State affected by the tides between the mean high watermark and either 100 rods seaward from the high watermark or the mean low watermark, whichever is closer to the mean high watermark. See Maine Revised Statutes Title 12 Sec. 572
  • Know: means to have actual knowledge. See Maine Revised Statutes Title 22 Sec. 2942
  • land: means real estate held by the State. See Maine Revised Statutes Title 12 Sec. 598
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • manufacturer: means a manufacturer of prescription drugs or biological products or an affiliate of the manufacturer or a labeler that receives prescription drugs or biological products from a manufacturer or wholesaler and repackages those drugs or biological products for later retail sale and that has a labeler code from the federal Food and Drug Administration under 21 Code of Federal Regulations, 2027. See Maine Revised Statutes Title 22 Sec. 2700-A
  • Multiple unit housing: shall mean a structure or structures located on a single lot, which structures are designed or used to house 2 or more families. See Maine Revised Statutes Title 12 Sec. 4807
  • Oath: includes an affirmation, when affirmation is allowed. See Maine Revised Statutes Title 1 Sec. 72
  • Oath: A promise to tell the truth.
  • Organ procurement organization: means a person designated by the United States Secretary of Health and Human Services as an organ procurement organization. See Maine Revised Statutes Title 22 Sec. 2942
  • Other land use activity: includes any commercial or industrial uses or combination of such uses. See Maine Revised Statutes Title 12 Sec. 4807
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Parent: means a parent whose parental rights have not been terminated. See Maine Revised Statutes Title 22 Sec. 2942
  • Part: means an organ, an eye or tissue of a human being. See Maine Revised Statutes Title 22 Sec. 2942
  • Person: means any individual, corporation, firm, partnership, municipality, quasi-municipal corporation, state or federal agency or any other legal entity. See Maine Revised Statutes Title 12 Sec. 4807
  • Person: means an individual, corporation, business trust, estate, trust, partnership, limited liability company, association, joint venture, public corporation, government or governmental subdivision, agency or instrumentality or any other legal or commercial entity. See Maine Revised Statutes Title 13 Sec. 5102
  • Person: means an individual, corporation, business trust, estate, trust, partnership, limited liability company, association, joint venture, public corporation, government or governmental subdivision, agency or instrumentality or any other legal or commercial entity. See Maine Revised Statutes Title 22 Sec. 2942
  • Physician: means an individual authorized to practice medicine or osteopathy under the law of any state. See Maine Revised Statutes Title 22 Sec. 2942
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • Prescriber: means a person who is licensed, registered or otherwise authorized in the appropriate jurisdiction to prescribe and administer drugs in the course of professional practice. See Maine Revised Statutes Title 22 Sec. 2700-A
  • Proceeds: means money arising or obtained from the sale of designated lands, excluding the costs of the sale. See Maine Revised Statutes Title 12 Sec. 598
  • Procurement organization: means an eye bank, organ procurement organization or tissue bank. See Maine Revised Statutes Title 22 Sec. 2942
  • Program-related asset: means an asset held by an institution primarily to accomplish a charitable purpose of the institution and not primarily for investment. See Maine Revised Statutes Title 13 Sec. 5102
  • Prospective donor: means an individual who is dead or near death and has been determined by a procurement organization to have a part that could be medically suitable for transplantation, therapy, research or education. See Maine Revised Statutes Title 22 Sec. 2942
  • Real estate held by the State: means real estate wholly owned by the State by fee simple title. See Maine Revised Statutes Title 12 Sec. 598
  • Reasonably available: means able to be contacted by a procurement organization without undue effort and willing and able to act in a timely manner consistent with existing medical criteria necessary for the making of an anatomical gift. See Maine Revised Statutes Title 22 Sec. 2942
  • Recipient: means an individual into whose body a decedent's part has been or is intended to be transplanted. See Maine Revised Statutes Title 22 Sec. 2942
  • Record: means information that is inscribed on a tangible medium or that is stored in an electronic or other medium and is retrievable in perceivable form. See Maine Revised Statutes Title 22 Sec. 2942
  • Record: means information that is inscribed on a tangible medium or that is stored in an electronic or other medium and is retrievable in perceivable form. See Maine Revised Statutes Title 13 Sec. 5102
  • Recovery agency: means an eye bank, organ procurement organization, tissue bank, educational institution or research organization that participates in or facilitates the execution of an anatomical gift. See Maine Revised Statutes Title 22 Sec. 2942
  • Reduced: means a reduction in the acreage of an individual parcel or lot of designated land under section 598?A. See Maine Revised Statutes Title 12 Sec. 598
  • Refusal: means a record created under section 2947 that expressly states an intent to bar other persons from making an anatomical gift of an individual's body or part. See Maine Revised Statutes Title 22 Sec. 2942
  • Regulated advertisement: means the presentation to the general public of a commercial message regarding a prescription drug or biological product by a manufacturer of prescription drugs that is:
    (1) Broadcast on television or radio from a station that is physically located in the State;
    (2) Broadcast over the Internet from a location in the State; or
    (3) Printed in magazines or newspapers that are printed, distributed or sold in the State. See Maine Revised Statutes Title 22 Sec. 2700-A
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
  • Service of process: The service of writs or summonses to the appropriate party.
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • Sign: means , with the present intent to authenticate or adopt a record:
  • A. See Maine Revised Statutes Title 22 Sec. 2942
  • Single family residential unit: means any structure of any kind, including mobile homes, used or designed to house a single family, and shall include those structures used permanently and seasonally. See Maine Revised Statutes Title 12 Sec. 4807
  • State: means a state of the United States, the District of Columbia, Puerto Rico, the United States Virgin Islands or any territory or insular possession subject to the jurisdiction of the United States. See Maine Revised Statutes Title 22 Sec. 2942
  • Statute: A law passed by a legislature.
  • Subsurface waste disposal: means any system for disposing of wastes or waste waters on or beneath the surface of the earth including, but not limited to, holding ponds, surface spraying, septic tanks, drainage fields and wells, but shall not include any discharge or the waste treatment system related thereto licensed under Title 38, section 413 or any discharge into a municipal or quasi-municipal sewer system. See Maine Revised Statutes Title 12 Sec. 4807
  • Technician: includes an enucleator. See Maine Revised Statutes Title 22 Sec. 2942
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • Tissue: means a portion of the human body other than an organ or an eye. See Maine Revised Statutes Title 22 Sec. 2942
  • Tissue bank: means a person that is licensed, accredited or regulated under federal or state law to engage in the recovery, screening, testing, processing, storage or distribution of tissue. See Maine Revised Statutes Title 22 Sec. 2942
  • Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
  • Transplant hospital: means a hospital that furnishes organ transplants and other medical and surgical specialty services required for the care of transplant patients. See Maine Revised Statutes Title 22 Sec. 2942
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • Waste: means any liquefied sewage, garbage, sewage sludge, chemical, biological or radiological materials, human body wastes, or any other refuse or effluent in a liquid form generated from domestic, commercial or industrial activities, except any wastes containing insufficient liquid to be free flowing and wastes generated from agricultural activities or animal husbandry. See Maine Revised Statutes Title 12 Sec. 4807
  • Well: means any hole constructed by any method for the purpose of extracting water from below the ground. See Maine Revised Statutes Title 12 Sec. 550-B
  • Well drilling company: means a person, firm, partnership or corporation that owns or otherwise operates any mechanical equipment used to drill, drive or bore water wells. See Maine Revised Statutes Title 12 Sec. 550-B
  • Writ: A formal written command, issued from the court, requiring the performance of a specific act.