LD 2423
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LD 2423 Title Page An Act to Allow Privately Acquired Catastrophic Insurance Coverage to Supplemen... Page 2 of 2
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LR 3428
Item 1

 
Be it enacted by the People of the State of Maine as follows:

 
Sec. 1. 22 MRSA §3174-T, sub-§2, śC, as reallocated by RR 1997, c. 2,
§46, is amended by adding at the end a new paragraph to read:

 
C. All children resident in the State are eligible except a
child who:

 
(1) Is eligible for coverage under the Medicaid
program;

 
(2) Is covered under a group health insurance plan or
under health insurance, as defined in Section 2791 of
the federal Public Health Service Act, 42 United States
Code, Section 300gg(c) (Supp. 1997);

 
(3) Is a member of a family that is eligible under
Title 5, section 285 for health coverage under the
state employee health insurance program;

 
(4) Is an inmate in a public institution or a patient
in an institution for mental diseases; or

 
(5) Within the 3 months prior to application for
coverage under the Cub Care program, was insured or
otherwise provided coverage under an employer-based
health plan for which the employer paid 50% or more of
the cost for the child's coverage, except that this
subparagraph does not apply if:

 
(a) The cost to the employee of coverage for the
family exceeds 10% of the family's income;

 
(b) The parent lost coverage for the child because
of a change in employment, termination of coverage
under the Consolidated Omnibus Budget
Reconciliation Act of 1985, COBRA, of the Employee
Retirement Income Security Act of 1974, as
amended, 29 United States Code, Sections 1161 to
1168 (Supp. 1997) or termination for a reason not
in the control of the employee; or

 
(c) The department has determined that grounds
exist for a good-cause exception.

 
Notwithstanding this paragraph, a child may not be deemed
ineligible for coverage under the Cub Care program solely
because the child is covered under a privately provided
catastrophic insurance policy or contract designed to
supplement coverage under the Cub Care program.


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