If you buy health insurance on the individual market, without help from an employer, you may want to know what Maine is doing to protect you from unfair and unnecessary premium rate increases. Here’s a summary of the Maine laws that govern rate increases.
- Maine has prior approval of individual market rates for insurers and HMO’s.
- Rates may not be “excessive, inadequate or unfairly discriminatory.” 24-A Me. Rev. St. § 2736; 24 Me. Rev. St. § 2321; 24-A Me. Rev. St. §4207.
- For individual insurance plans, the insurer must file rate information with both the Superintendent of Insurance and the Attorney General. Rates must be filed at least 60 days prior to their effective date, unless this requirement is waived by the Superintendent. The effective date may be suspended by the Superintendent for 30 days. 24-A Me. Rev. St. § 2736; 24 Me. Rev. St. § 2321.
- If the Superintendent or the Attorney General has cause to believe the filing does not meet this standard, he or she “shall cause a hearing to be held.” 24-A Me. Rev. St. § 2736-A. The Superintendent must issue an order approving or disapproving the rate filing within 30 days of the hearing. If the Superintendent disapproves the filing, he or she must specify in the order the filing that he or she would approve. 24-A Me. Rev. St. § 2736-B.
- The insurer must provide written notice of proposed rate increases to all policyholders at least 60 days before the effective date. The notice must also inform policyholders of their right to request a hearing. The Superintendent may not take action on a rate filing until at least 40 days after the date the notice is mailed to policyholders. 24-A Me. Rev. St. § 2735-A.
- For HMO’s, if the Superintendent does not approve or disapprove a rate request, it is deemed approved 30 days after it was filed. 24-A Me. Rev. St. §4207.