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AGENCY UMBRELLA-UNIT NUMBER: 02-031
AGENCY NAME: Department of Professional and Financial Regulation, Bureau of Insurance

CONTACT PERSON: Thomas M. Record, Esq., Senior Staff Attorney, 34 State House Station, Augusta, ME 04333-0034. Tel: (207) 624-8424

EMERGENCY RULES ADOPTED SINCE THE LAST REGULATORY AGENDA: None

CONSENSUS-BASED RULE DEVELOPMENT: A consensus-based rule development within the meaning of 1999 P.L. c. 307 is being used in formulating proposed amendments to Rule Chapter 450..

EXPECTED 2004-2005 RULEMAKING ACTIVITY:

CHAPTER 250: Workers' Compensation Self-Insurance
STATUTORY AUTHORITY: 24-A M.R.S.A. §212 and 39-A M.R.S.A. §403
PURPOSE: to amend current rule to reflect a recent statutory change relating to the working capital offset provision for security calculations and other changes necessary to reflect current business practices.
ANTICIPATED SCHEDULE: Late 2004
AFFECTED PARTIES: Workers Compensation Self-Insurers

CHAPTER 450: Workers' Compensation Experience Rating
STATUTORY AUTHORITY: 24-A M.R.S.A. §§212 and 2382-D(4)
PURPOSE: to amend current rule to include adjustment to the experience rating plan to exclude consideration of lost-time claims attributable to injuries that are aggravations, or combine with prior lost-time claims.
ANTICIPATED SCHEDULE: A concensus-based development process is being utilized to develop proposed amendments.
AFFECTED PARTIES: Workers' Compensation Insurers, Employers

CHAPTER 530: Provisional Medical or Disability Payments to Workers' Compensation Claimants
STATUTORY AUTHORITY: 24-A M.R.S.A. §212 and 39-A M.R.S.A. §222(3)
PURPOSE: to clarify the status of the MaineCare program under the Rule.
ANTICIPATED SCHEDULE: Winter 2004-05
AFFECTED PARTIES: Workers' Compensation Insurers and Self-Insurers, MaineCare

CHAPTER 561: Worker' Compensation Insurance - Employee Leasing (Replaces Current Rule Chapter 560)
STATUTORY AUTHORITY: 24-A M.R.S.A. §§ 212, 2178, 2382-B, and 2386; 32 M.R.S.A. § 14055(2).
PURPOSE: to replace the current rule to reflect statutory changes that have occurred since rule's adoption in 1992, to require that all workers' compensation insurance coverage issued to employee leasing companies be written on a multiple coordinated basis and to make other miscellaneous changes based on the Bureau's experience with the Rule
ANTICIPATED SCHEDULE: Pending
AFFECTED PARTIES: Workers' Compensation Insurers, Employee Leasing Companies, NCCI

NEW RULE: Workers Compensation Insurance - Group Self-Insurance Reinsurance Vehicles
STATUTORY AUTHORITY: 24-A M.R.S.A. §212 and 39-A M.R.S.A. §403(4-A)(J)
PURPOSE: to administer and effectuate the intent of 39-A M.R.S.A. §403(4-A)
ANTICIPATED SCHEDULE: as determined necessary
AFFECTED PARTIES: Workers' compensation insurers group self-insurers

Property and Casualty Insurance

NEW RULE: Criteria for the Establishment of a Mandatory Market Assistance Plan
STATUTORY AUTHORITY: 24-A M.R.S.A. §§212 and 2325-B(2)
PURPOSE: to establish the level of insufficient participation in a voluntary market assistance plan that would be necessary for the establishment of a mandatory market assistance plan.
ANTICIPATED SCHEDULE: as determined necessary
AFFECTED PARTIES: Property insurers, Homeowners

NEW RULE: Mandatory Market Assistance Plan
STATUTORY AUTHORITY: 24-A M.R.S.A. §212 and 2325-B (4) and (8)
PURPOSE: to establish standards for a mandatory market assistance plan as contemplated in authorizing legislation.
ANTICIPATED SCHEDULE: as determined necessary
AFFECTED PARTIES: Property insurers, Homeowners

Health Insurance

Amendments to CHAPTER 130: Minimum Reserve Standards for Individual and Group Health Insurance Contracts
STATUTORY AUTHORITY: 24-A M.R.S.A. §§212 and 925
PURPOSE: to update current rule to reflect revised disability insurance actuarial tables and recent amendments to the NAIC Model Rule.
ANTICIPATED SCHEDULE: Summer 2005
AFFECTED PARTIES: Disability insurers

Amendments to CHAPTER 220: Credit Life and Health Insurance
STATUTORY AUTHORITY: 24-A M.R.S.A. Chapter 37
PURPOSE: To amend current rule to clarify procedures for rate deviations and refund calculations and to specify what constitutes "premiums" for purposes of determining the maximum permissible commission level
ANTICIPATED SCHEDULE: Late 2005
AFFECTED PARTIES: Consumers who purchase credit insurance, credit life and health insurers

Amendments to Rule CHAPTER 275: Medicare Supplement Insurance
STATUTORY AUTHORITY: 24-A M.R.S.A. §212 and Chapter 67
PURPOSE: to reflect changes in the NAIC Model Medicare Supplement Insurance Regulation that may be adopted in light of recent changes in the federal Medicare law.
ANTICIPATED SCHEDULE: Winter 2004-05
AFFECTED PARTIES: Medicare supplement insurers

Amendment to Rule Chapter 750: Standardized Health Plans (major substantive rule)
STATUTORY AUTHORITY: Title 24-A M.R.S.A. §§ 4202-A(1), 4204(2-A)(O), and 212
PURPOSE: to allow health carriers to offer plans that comply with the high deductible health plan requirements of Section 223 of the U.S. Internal Revenue Code
ANTICIPATED SCHEDULE: Winter 2004-05
AFFECTED PARTIES: HMOs

NEW RULE : Electronic Claims Submission; Hardship Exemptions
STATUTORY AUTHORITY: 24 M.R.S.A. §2985
PURPOSE: to define the standards for "hardship exemptions" from the responsibility of small health care practitioners to file claims electronically.
ANTICIPATED SCHEDULE: Spring 2005
AFFECTED PARTIES: Small health care practitioners, health insurers, HMOs

Miscellaneous

CHAPTER 230: Requirements for a Certificate of Authority
STATUTORY AUTHORITY: 24-A M.R.S.A. §212
PURPOSE: to implement clarifying changes recommended during Rule Review Process and other miscellaneous changes
ANTICIPATED SCHEDULE: Winter-Spring 2005
AFFECTED PARTIES: Applicants for authority to transact insurance

Amendments to CHAPTER 780: Actuarial Opinion and Memorandum
STATUTORY AUTHORITY: 24-A M.R.S.A. §§212 and 952-A
PURPOSE: to reflect recent amendments to the NAIC Actuarial Opinion and Memorandum Model Regulation
ANTICIPATED SCHEDULE: Summer 2005
AFFECTED PARTIES: Life insurers, fraternal benefit societies

Amendments to CHAPTER 930: Viatical Settlements
STATUTORY AUTHORITY: 24-A M.R.S.A. 212 and 6810
PURPOSE: to reflect statutory changes enacted by 2003 PL c. 636
ANTICIPATED SCHEDULE: Summer 2005
AFFECTED PARTIES: Viatical and life settlement companies

NEW RULE: Privacy
STATUTORY AUTHORITY: 24-A M.R.S.A. §2220
PURPOSE: to carry out the purposes of the Insurance Information and Privacy Act
ANTICIPATED SCHEDULE: as determined necessary
AFFECTED PARTIES: Insurers, Insurance Consumers

revised on December 27, 2004

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