02-031-281 Me. Code R. § 3

Current through 2024-46, November 13, 2024
Section 031-281-3 - Comprehensive Medical Expense Benefits

If the group insurance policy from which conversion is made insures the employee or member, with or without dependent coverage, for comprehensive medical expense benefits, the insurer may offer, in lieu of the plans of benefits set forth in paragraphs 1 and 2 above, a choice between the plans of benefits set forth in paragraph 1 and a policy of Comprehensive Medical Expense Benefits without first dollar coverage. Said policy shall conform to the requirements of paragraph 2 above provided, however, that an insurer electing to offer such a policy shall make available a low deductible option not to exceed $100, a high deductible option between $500 and $1,000, and a third deductible option midway between the high and low deductible option.

B. Nonprofit Hospital, Medical and Health Care Service Organizations.

If the group contract from which conversion is made provides the employee or member, with or without dependent coverage, hospital, medical, or health care benefits; the covered individuals shall be entitled to obtain non-group coverage or, at the option of the nonprofit organization, a group certificate providing the same choice of coverage customarily being offered to non-group applicants. If no such non-group contracts are being issued, the converted coverage must be identical to the group coverage being terminated.

02-031 C.M.R. ch. 281, § 3