HP0549
LD 769
Session - 128th Maine Legislature
C "A", Filing Number H-143, Sponsored by
LR 1553
Item 2
Bill Tracking, Additional Documents Chamber Status

Amend the bill by striking out the title and substituting the following:

‘An Act To Reduce Insurance Rate Variability Due to Geographic Location or Tobacco Use and To Maintain Current Rating Based on Age and Group Size’

Amend the bill in section 1 by striking out all of paragraph C-1 (page 1, lines 4 to 11 in L.D.) and inserting the following:

C-1. A carrier may vary the premium rate due to geographic area in accordance with the limitation set out in this paragraph. For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after between July 1, 2012 and December 31, 2018, the rating factor used by a carrier for geographic area may not exceed 1.5. For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2019, the rating factor used by a carrier for geographic area may not exceed 1.2.

Amend the bill in section 2 in paragraph D by striking out all of subparagraphs (7) and (8) (page 1, lines 39 to 41 and page 2, lines 1 to 13 in L.D.) and inserting the following:

(7) For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after between January 1, 2015 and December 31, 2018, the maximum rate differential due to age filed by the carrier as determined by ratio is 5 to 1 to the extent permitted by the federal Affordable Care Act. The limitation does not apply for determining rates for an attained age of less than 19 years of age or more than 65 years of age. For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2019, the maximum rate differential due to age filed by the carrier as determined by ratio is 3 to 1. The limitation does not apply for determining rates for an attained age of less than 19 years of age or more than 65 years of age.

(8) For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after between July 1, 2012 and December 31, 2018, the maximum rate differential due to tobacco use filed by the carrier as determined by ratio is 1.5 to 1. For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2019, the maximum rate differential due to tobacco use filed by the carrier as determined by ratio is 1.2 to 1.

Amend the bill in section 3 in paragraph I by striking out all of subparagraphs (5) and (6) (page 3, lines 1 to 16 in L.D.) and inserting the following:

(5) For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after between January 1, 2016 and December 31, 2018, the maximum rate differential due to age filed by the carrier as determined by ratio is 5 to 1 to the extent permitted by the federal Affordable Care Act. The limitation does not apply for determining rates for an attained age of less than 19 years of age or more than 65 years of age. For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2019, the maximum rate differential due to age filed by the carrier as determined by ratio is 3 to 1. The limitation does not apply for determining rates for an attained age of less than 19 years of age or more than 65 years of age.

(6) For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after between July 1, 2012 and December 31, 2018, the maximum rate differential due to tobacco use filed by the carrier as determined by ratio is 1.5 to 1. For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2019, the maximum rate differential due to tobacco use filed by the carrier as determined by ratio is 1.2 to 1.

Amend the bill in section 4 by striking out all of paragraph C-1 (page 3, lines 23 to 30 in L.D.) and inserting the following:

C-1. A carrier may vary the premium rate due to geographic area in accordance with the limitation set out in this paragraph. For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after between October 1, 2011 and December 31, 2018, the rating factor used by a carrier for geographic area may not exceed 1.5. For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2019, the rating factor used by a carrier for geographic area may not exceed 1.2.

Amend the bill in section 5 in paragraph D in subparagraph (8) in the 3rd line (page 4, line 30 in L.D.) by striking out the following: " 2017" and inserting the following: ' 2018'

Amend the bill in section 5 in paragraph D by striking out all of subparagraphs (9) to (13) (page 4, lines 35 to 44 and page 5, lines 1 to 12 in L.D.) and inserting the following:

(9) For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after between October 1, 2011 and December 31, 2018, the maximum rate differential due to tobacco use filed by the carrier as determined by ratio is 1.5 to 1. For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2019, the maximum rate differential due to tobacco use filed by the carrier as determined by ratio is 1.2 to 1.

(10) For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2019, the maximum rate differential due to age and group size filed by the carrier as determined by ratio is 3 to 1. The limitation does not apply for determining rates for an attained age of less than 19 years of age or more than 65 years of age.

Amend the bill in section 6 in paragraph H in subparagraph (5) in the 3rd line (page 6, line 5 in L.D.) by striking out the following: " 2017" and inserting the following: ' 2018'

Amend the bill in section 6 in paragraph H by striking out all of subparagraphs (6) to (10) (page 6, lines 10 to 31 in L.D.) and inserting the following:

(6) For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after between October 1, 2011 and December 31, 2018, the maximum rate differential due to tobacco use filed by the carrier as determined by ratio is 1.5 to 1. For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2019, the maximum rate differential due to tobacco use filed by the carrier as determined by ratio is 1.2 to 1.

(7) For all policies, contracts or certificates that are executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2019, the maximum rate differential due to age and group size filed by the carrier as determined by ratio is 3 to 1. The limitation does not apply for determining rates for an attained age of less than 19 years of age or more than 65 years of age.

summary

This amendment is the minority report of the committee. The amendment reduces the maximum rate differential in premium rates for individual and small group health insurance policies on or after January 1, 2019 on the basis of geographic area from 1.5 to 1.2 and tobacco use as determined by ratio from 1.5 to 1 to 1.2 to 1 and maintains the rate differential due to age and group size at 3 to 1. The bill prohibits insurance carriers providing individual health plans or small group health plans from varying premium rates based on age, geographic location or tobacco use on or after January 1, 2018.


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