Rep. Marygrace Cimino

Maddy summaryLD 520 modifies Maine's health insurance market rules to standardize plan options and simplify choices. It requires health insurance carriers to offer individual and small group plans through a "pooled market" with standardized cost-sharing structures (copays, deductibles) for bronze, silver, gold, and platinum tiers, eliminating rate differences based on whether a plan is sold to individuals or small employers. The Maine Insurance Superintendent must develop these standardized "clear choice designs" annually, releasing proposed versions by January 31 for stakeholder review, and allows carriers to offer up to three alternative plan designs per tier if they pass actuarial review. This directly affects insurers selling plans in Maine and consumers purchasing individual or small group coverage, aiming to reduce confusion and promote price/quality competition.