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Home > Agendas > 2005-2006 > P&FR > Bureau of Insurance

2005-2006 Regulatory Agendas

02-031
Bureau of Insurance

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 2005-2006 RULEMAKING ACTIVITY:

From the Filing dated September, 2005

Workers’ Compensation Insurance

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: Winter 2005-06
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 consensus-based development process is being utilized to develop proposed amendments.
AFFECTED PARTIES: Workers’ Compensation Insurers, Employers

Property and Casualty Insurance

NEW RULE: Rules of Practice and Procedure Governing Adjudicatory Proceedings Held Under the Maine Property and Automobile Insurance Cancellation Control Acts
STATUTORY AUTHORITY: 24-A M.R.S.A. §§ 212, 2920, and 3054
PURPOSE: to adopt rules of practice and procedure applicable to administrative hearings held under the Maine Property and Automobile Insurance Cancellation Control Acts
ANTICIPATED SCHEDULE: Fall-Winter 2005
AFFECTED PARTIES: property and casualty insurers and policyholders

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: Winter2005
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 750: Standardized Health Plans
STATUTORY AUTHORITY: 24 M.R.S.A. Chapter 19, and Title 24-A M.R.S.A. §§ 212, 2736-C(6)(F), 2736-C(8), 4222-A, and 4222-B
PURPOSE: to redesign standards for HMO plans in order to increase plan viability
ANTICIPATED SCHEDULE: Spring 2006
AFFECTED PARTIES: HMOs

Amendment to Rule CHAPTER 940: Requirements for Health Insurance Rate Filings and Data Reporting
STATUTORY AUTHORITY: 2005 Public Law Chapter 121
PURPOSE: to reflect statutory change in the credibility standard for small group guaranteed loss ratios
ANTICIPATED SCHEDULE: Winter 2005-06
AFFECTED PARTIES: Health insurers, HMOs

NEW RULE: Minimum Amount for Required Interest Payments by Insurers
STATUTORY AUTHORITY: 2005 PL c. 50
PURPOSE: to adopt a de minimis amount of interest on late claim payments below which insurers do not have to remit payment.
ANTICIPATED SCHEDULE: Winter 2005-06
AFFECTED PARTIES: Insurers, health care providers, insureds

Miscellaneous

Amendments to CHAPTER 541: Educational Requirements for Insurance Professionals
STATUTORY AUTHORITY: 24-A M.R.S.A. §§ 212, 601(23), 1423(3)(A), 1483(2), and 1485
PURPOSE: to update in light of statutory changes and national uniformity initiatives
ANTICIPATED SCHEDULE: Winter 2005-06
AFFECTED PARTIES: Insurance producers

Amendments to CHAPTER 630: Rural Medical Access Program
STATUTORY AUTHORITY: 24-A M.R.S.A. §§ 212, 229(1) and 6311
PURPOSE: to reflect statutory changes enacted by 2005 PL c. 122
ANTICIPATED SCHEDULE: Spring 2006
AFFECTED PARTIES: Physicians, Medical Mutual Insurance Company

Amendments to CHAPTER 740: Credit for Reinsurance
STATUTORY AUTHORITY: 24-A M.R.S.A. §731-B
PURPOSE: to modernize and conform to NAIC initiatives
ANTICIPATED SCHEDULE: Late 2005
AFFECTED PARTIES: Insurers

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: Winter 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: Fall 2005
AFFECTED PARTIES: Viatical and life settlement companies

NEW RULE: Senior Protection in Annuity Transactions
STATUTORY AUTHORITY: 24-A M.R.S.A. §§ 212 and 2517
PURPOSE: to set forth standards and procedures for recommendations to senior consumers that result in a transaction involving annuity products so that the insurance needs and financial objectives of senior consumers at the time of the transaction are appropriately addressed.
ANTICIPATED SCHEDULE: Winter 2005-06
AFFECTED PARTIES: Annuity underwriters, annuity producers

NEW RULE: Life Insurance and Annuities Replacement
STATUTORY AUTHORITY: 24-A M.R.S.A. §§ 212 and 2517
PURPOSE: to protect the interests of life insurance and annuity purchasers by establishing minimum standards of conduct to be observed in replacement or financed purchase transactions
ANTICIPATED SCHEDULE: Winter 2005-06
AFFECTED PARTIES: Life Insurers and Producers, Annuity Issuers and Producers

Additional Items from the filing dated July, 2005

Worker’s Compensation Insurance

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: Pending
AFFECTED PARTIES: Workers' Compensation Insurers and Self-Insurers, MaineCare

NEW RULE: Criteria for the Establishment of a Mandatory Market Assistance Plan
STATUTORY AUTHORITY: 24-A M.R.S.A. §§ 212 and 2325-8(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 2325-8 (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 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: Pending
AFFECTED PARTIES: Medicare supplement insurers

Proposed New Rule CHAPTER 825: 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: Pending
AFFECTED PARTIES: small health care practitioners, health insurers, HMOs

Miscellaneous

CHAPTER 231: Requirements for a Certificate of Authority (will replace current Rule Chapter 230)
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: Pending
AFFECTED PARTIES: Applicants for authority to transact insurance

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