Maine Rate Review Grants Award List
Cycle I Grant Application Summary
Maine Grantee: The Maine Bureau of Insurance
Award Date: August 16, 2010
Award Amount: $1,000,000
- Expand the Scope of the Review Process: Currently, Maine has prior approval review authority for all individual and small group market products. Carriers may elect to meet a three-year average medical loss ratio guarantee (meaning they will spend a certain percentage of premium dollars on medical care rather than overhead or profits) and avoid prior approval in the small group. Maine will expand its current practice of health insurance premium review by collecting and analyzing small group market data from carriers electing the loss ratio to inform the Department if additional statutory authority is needed.
- Improve the Review Process: At present, Maine’s informational filings lack sufficient detail to determine full compliance with the law. The State plans to collect additional information on small group rates. Additionally, Maine will collect historical and projected cost and utilization trend data to establish benchmarks.
- Increase Transparency and Accessibility: Maine posts extensive rate filing information on its website, and encourages consumer participation in the rate filing process by hosting field hearings in addition to formal hearings. Maine will encourage increased participation of consumer advocacy groups in rate hearings and will compile submitted rate filing information into a consumer-friendly format for posting on its website.
- Develop and Upgrade Technology: Maine will upgrade its systems to improve efficiency and aid in the health insurance premium review process. The State will also establish a data center to compile and publish fee schedule information.
Last updated: September 21, 2012