| | | 1-B. Notification of availability of individual coverage. An | | insurer must provide forms to group policyholders and certificate | | holders as required in subsection 1-A for the purpose of | | informing terminating group members of their right to purchase | | any individual health plan available in this State. An adequate | | supply of forms must be provided to each group policyholder when | | the policy is issued and at least annually thereafter. The | | superintendent may prescribe the content of the form by routine | technical rule pursuant to Title 5, chapter 375, subchapter II-A | | 2-A. The form must include at least the following: |
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| | | A. A statement that all state residents not eligible for | | Medicare have a right to purchase any individual health plan | | available in this State; |
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| | | B. A statement that in order to avoid a gap in coverage, | | the individual should apply for individual coverage prior to | | termination of group coverage; |
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| | | C. A statement that if more than 90 days pass between the | | time the group coverage ends and the time individual | | coverage begins, the individual coverage may exclude | | preexisting conditions for one year; and |
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| | | D. A statement that information concerning individual | | coverage is available from the Bureau of Insurance. The | | bureau's toll-free telephone number must also be provided. |
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| | | Sec. 5. 24-A MRSA §4209, sub-§6, as enacted by PL 1995, c. 189, §3 and | | affected by §4, is amended to read: |
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| | | 6. Notification of cancellation. A health maintenance | | organization must provide by first class mail at least 10 days' | | prior notification of cancellation for nonpayment of enrollment | | charges according to this section. The notice must include the | | date of cancellation of coverage and the time period for | | exercising contract conversion rights. Notification is not | | required when the insurer has received written notice from the | | group contract holder that replacement coverage has been | | obtained. |
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| | | A. Notice must be mailed to the group contract holder or | | subgroup sponsor. |
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| | B. At the time of notification under paragraph A, notice | must be mailed to the individual enrollee at: |
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| | (1) The last address provided by the group contract | holder to the health maintenance organization; or |
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