‘ 1. Access payments required from health insurance carriers, 3rd-party administrators and employee benefit excess insurance carriers. All health insurance carriers, 3rd-party administrators and employee benefit excess insurance carriers shall pay an access payment as specified in paragraph A on all paid claims, except claims under accidental injury, specified disease, hospital indemnity, dental, vision, disability income, long-term care, Medicare supplement or other limited benefit health insurance.
The following provisions govern access payments.
A. The amount of the access payment is established as follows:
(1) From September 1, 2009 to August 31, 2010, the access payment is 2.14%;
(2) From September 1, 2010 to August 31, 2011, the access payment is 1.605%;
(3) From September 1, 2011 to August 31, 2012, the access payment is 1.07%;
(4) From September 1, 2012 to August 31, 2013, the access payment is 0.535%; and
(5) Beginning September 1, 2013, a health insurance carrier, 3rd-party administrator and employee benefit excess insurance carrier is not required to pay an access payment.
A health insurance carrier or employee benefit excess insurance carrier may not be required to pay an access payment on policies or contracts insuring federal employees.
B. Access payments apply to claims paid beginning on or after September 1, 2009.
C. Access payments must be made monthly to Dirigo Health, are due 30 days after the end of each month and must accrue interest at 12% per annum on or after the due date, except that access payments for 3rd-party administrators for groups of 500 or fewer members may be made annually not less than 60 days after the close of the plan year.
D. Access payments received by Dirigo Health must be pooled with other revenues of the agency in the Dirigo Health Enterprise Fund established in section 6915.’
