LD 1181
pg. 1
LD 1181 Title Page An Act To Provide Fair Hearings in Health Insurance Rate Proceedings Page 2 of 4
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LR 1341
Item 1

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

 
Sec. 1. 24-A MRSA §235-A is enacted to read:

 
§235-A.__Rate hearings

 
A rate hearing must be conducted with respect to all filings
of rates, rating formulas and modifications for health
insurance policies offered by a carrier in this State in
accordance with the requirements of this section.

 
1.__Criteria for rate hearings.__In any filing of rates,
rating formulas and modifications for health insurance
policies when the requested rates or modifications exceed the
Consumer Price Index by 100% or more, a rate hearing must be
conducted pursuant to subsection 2.

 
2.__Hearings.__A hearing conducted with respect to rate
filings must be held in the manner provided for in Title 5,
chapter 375, subchapter 4 and meet the requirements in this
subsection.

 
A.__The hearing must be conducted by an impartial
administrative hearing officer other than the
superintendent or an employee of the bureau.__The hearing
officer must have sufficient qualifications in education
and professional experience and training to preside over
adjudicatory and administrative hearings.

 
B.__Actuarial staff from the bureau shall provide a
written analysis and report to the administrative hearing
officer that includes at least the following:

 
(1)__An opinion as to whether the rates requested by
the carrier are reasonable relative to the benefits
and coverage offered;

 
(2)__Information regarding the impact of the
requested rates on affordability for policyholders by
age group; and

 
(3)__Identification of any coverage or benefit
changes that have occurred during the 2-year period
preceding the date of the rate request that would
reduce the risks or costs to the carrier.

 
C.__A report submitted pursuant to paragraph B is a public
record as defined in Title 1, section 402, subsection 3 and
must be provided to any advocacy panel under subsection 3
involved in a rate hearing at least 40 days prior to the


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