Data Reporting Requirements

286-A (Supplemental Health Insurance Reporting Form)

940 (Health Insurance Annual Data Report)

945 (Maine Annual Report Supplement)

Short Form - Completed by companies with less than $5 million in direct written Health insurance premium for major medical and stop loss combined Long Form - Completed by companies with $5 million or more in direct written Health insurance premium for major medical and stop loss combined

Aggregate Workers' Compensation Benefits Paid Report

Insurance Carrier Aggregate Benefits Paid Report

Self-Insurance Aggregate Benefits Paid Report

Any Willing Pharmacy - Bulletin 377

Carrier Report

Comparable Health Care Service Incentive Program Report 

Only carriers offering small group plans compatible with a Health Savings Account should file this report. Notices will be sent to those companies that must file it.

Credit Disability Insurance Experience Report

Credit Life Insurance Summary Report

Data Security Act

Employee Benefit Excess Insurance

Only Companies with written premium for Stop Loss should file this report. Notices will be sent to those companies that must file.

Fraud and Abuse Annual Report

Health Plans Providing Prescription Drug Benefits Report

Only carriers that issue health plans with prescription drug benefits need to complete this form.

Health Report Card Survey

Liquor Liability

Long-Term Care Insurance Reporting (Rule 425)

Mandated Benefits

Medical Malpractice Liability Claim Report

Physician Tiering

Self-Insurance Annual Payroll Report

Tickborne Disease Report

Workers' Compensation Insurance Market Survey

The documents on this page are also available in hard copy by contacting the Bureau.