Preferred Provider Arrangements

^{IMPORTANT NOTICE:  The Maine Bureau of Insurance has revised the process for renewing and applying for Preferred Provider Arrangements.}

^{Starting 2024, ALL PPO Annual Renewal Registrations and Annual Experience reporting MUST be filed in electronic format and must include a full and complete submission at: ALMSOnline}

^{Carriers and Administrators MUST Renew and Pay Online to continue your registration for one year.}

<sup>PAPER AND EMAIL SUBMISSIONS ARE NO LONGER BEING ACCEPTED.

PAPER CHECKS AND CREDIT/DEBIT CARD PAYMENTS BY PHONE OR MAIL ARE NO LONGER ALLOWED - PAYMENT MUST BE MADE ONLINE.</sup>

^{Under this new format, companies can only upload documents using the following allowable filetypes: .bmp, .jpg, .docx, .png, .pdf, .csv, .xls, outlook, .txt.   There is no restriction on the number of documents you can upload, but there is a 10MB size limit per document.  You may split documents into multiple parts to accommodate the size restriction, if needed.}

^{Please refer to the email notification that you will be receiving shortly for further instructions.}

NOW ACTIVE  - Apply for New PPO Registration Online:

Carriers and Administrators can now apply for a new PPO Registration electronically at: ALMSOnline

PPO Registration Changes:

You may now make changes to your PPO Registration electronically. This new feature will allow you to change the following information online instantly:

• Renew registration
• Check the Status of an Application
• Update registration information
• General Information Submittal
• Submission of Material Change Reports
• Requesting a copy of registration

Please go to the following link if there have been any subsequent changes in information previously provided with the original application of which the Superintendent has not been advised, please update at: ALMSOnline

All contact information must be updated by 12/31 each year to receive timely renewal notices via email.

General Instructions and Application Requirements

The Maine Bureau of Insurance is providing copies of the online application below for your convenience, so you can prepare all pertinent information and documentation prior to initiating your application online.  Please note these application requirement documents are not to be used as substitutions for the electronic forms online.

General Instructions

• General Instructions (PDF)

PPA Carrier Specific Instructions and Requirements

• PPA Carrier Instructions (PDF)

• PPA Carrier Initial Registration Application Requirements (PDF)

PPA Administrator Specific Instructions and Requirements

• PPA Administrator Instructions (PDF)

• PPA Administrator Initial Registration Application Requirements (PDF)

PPA Annual Renewal Registration and Experience Report Requirements for Carriers and Administrators

• PPA Annual Registration Application Requirements (PDF)

Annual Reporting Requirements

• Health Report Card Survey This form is due by March 1 each year.  Information should be reported for the prior calendar year (January 1 – December 31). This information is a requirement of 24-A, M.R.S. § 4302(2).  Return this form by e-mail to Violet.M.Hyatt@maine.gov.
   
• Any Willing Pharmacy (Bulletin 377)

Fees

• Company Renewal Dates and Fees (PDF)
• Fee Schedule - (Scroll to Item 20)

Requesting Confidential Treatment of Documents

• Instructions for Requesting Confidential Treatment of Documents with the Bureau of Insurance

Statutory Requirements

• Title 24-A M.R.S.A. Chapter 32 (Preferred Provider Arrangement Act)
• Title 24-A M.R.S.A Chapter 56-A (Health Plan Improvement Act)
• Rule Chapter 360 (DOC) (Requirements Applicable to Preferred Provider Arrangements)
• Rule Chapter 850 (DOC) (Health Plan Accountability)

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