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STATE OF MAINE
Title 24-A M.R.S.A. § 2736(1) requires that insurance carriers obtain the approval of the Superintendent of Insurance for proposed policy rates for non-group health insurance products. On May 5, 2008 and pursuant to § 2736(1), MEGA Life and Health Insurance Company (“MEGA”) submitted a rate filing for its individual health products.
After hearing on October 3, 2008, the Superintendent issued a December 1, 2008 Decision and Order that, among other things:
The December 1, 2008 Decision and Order’s discussion of law and facts is incorporated herein by reference.
On December 19, 2008, MEGA made a compliance filing, requesting those rates the Superintendent indicated as acceptable in her December 1, 2008 Decision and Order, except for rates for MEGA’s Mental Health Parity Benefit Rider Form 25945-IR ME when attached to Form 25876-IP ME. The Superintendent promptly inquired about the apparently noncompliant rates for MEGA’s Mental Health Parity Benefit Rider Form 25945-IR ME when attached to Form 25876-IP ME, MEGA.
On January 8, 2009, in response to inquiry from the Superintendent, MEGA amended its December 19, 2008 compliance filing. The amendment eliminated an error in calculation that had made proposed rates for MEGA’s Mental Health Parity Benefit Rider Form 25945-IR ME when attached to Form 25876-IP ME noncompliant with the Superintendent’s December 1, 2008 Decision and Order.
For reasons set forth in her December 1, 2008 Decision and Order, the Superintendent finds that MEGA’s December 19, 2008 compliance filing, as amended by its January 8, 2009 filing regarding Mental Health Parity Benefit Rider Form 25945-IR ME, requests rates that are not excessive, inadequate, or unfairly discriminatory and that otherwise meet applicable standards for acceptance.
Pursuant to the provisions of 24-A M.R.S.A. §§ 211 and 2736-B and authority otherwise conferred by law, the Superintendent hereby ORDERS:
NOTICE of APPELLATE RIGHTS
This Decision and Order is final agency action as defined by 5 M.R.S.A. § 8002(4). It may be appealed to the Superior Court in the manner provided for by 24-A M.R.S.A. § 236, 5 M.R.S.A. §§ 11001 through 11008, and M.R. Civ.P. 80C. Any party to the proceeding may initiate an appeal within thirty days after receiving this notice. Any aggrieved non‑party whose interests are substantially and directly affected by this Decision and Order may initiate an appeal within forty days of the issuance of this decision. There is no automatic stay pending appeal. Application for stay may be made in the manner provided in 5 ;M.R.S.A. § 11004.
Last Updated: January 16, 2014
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