United States — Maine Act or statute

United States — Maine legislation

Maine Revised Statutes, Title 24-A, § 2816: Requirements, 1969

Group or blanket health insurance policies sold in this state must include the listed required provisions, unless section 2829 applies; insurers must also offer certificate holders review and arbi…

health insuranceinsurance policy conditionsmedical expense reimbursementreview and arbitration

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01

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“Group or blanket health insurance policies sold in this state must include the listed required provisions, unless section 2829 applies; insurers must also offer certificate holders review and arbitration for certain medical expense reimbursement denials, with ERISA-group and similar voluntary-review exceptions.”

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    Enacted 1969 · Source version 1 Oct 2025. The date shown identifies this source expression and should not be treated as proof that no later change exists.

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Requirements

Group or blanket health insurance policies sold in this state must include the listed required provisions, unless section 2829 applies; insurers must also offer certificate holders review and arbitration for certain medical expense reimbursement denials, with…

Section 2816

04

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Source record from legislature.maine.gov · Enacted 1969 · Source version 1 Oct 2025

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Amendment
§ 2816RequirementsAmendment

Group or blanket health insurance policies sold in this state must include the listed required provisions, unless section 2829 applies; insurers must also offer certificate holders review and arbitration for certain medical expense reimbursement denials, with ERISA-group and similar voluntary-review exceptions.

No policy of group or blanket health insurance shall, except as provided in section 2829, be delivered or issued for delivery in this State, unless the policy contains in substance each and all of the provisions set forth in sections 2817 to 2828, or provisions which in the opinion of the superintendent are more favorable to the holders of such certificates or not less favorable to the holders of such certificates and more favorable to policyholders. Insurers offering policies under this chapter shall offer to certificate holders the right of review and arbitration set forth in section 2747, subsection 1, with respect to denials of medical expense reimbursement benefits based upon the grounds set forth in section 2747, subsection 2, except that the requirement of section 2747, subsection 1 shall not apply to certificate holders in groups subject to the United States Employee Retirement Income Security Act of 1974, Public Law 93-406, as amended, or to any policy or certificate holder to whom the insurer voluntarily extends a review similar to that which it provides to persons insured under group policies subject to that Act. [PL 1981, c. 698, §110 (AMD).]
Section 2816Verify source

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  • 1 Oct 2025 · currentEnglish

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