An Act To Help Maine Residents Receive Private Health Care Insurance
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 22 MRSA §18-A is enacted to read:
§ 18-A. Enrollment in employer-sponsored health insurance; conditions of eligibility
1. Condition for eligibility. The department shall require, as a condition of being or remaining eligible for medical assistance, an individual otherwise entitled to medical assistance under this Title to apply for enrollment in an employer-sponsored group health plan in which the individual or the individual's dependents, including dependents up to 26 years of age, are otherwise eligible to be enrolled.
2. Private health insurance premium program. Except as otherwise provided in section 18, the department is not responsible for payments of any premiums, deductibles, coinsurance and other cost-sharing obligations of an individual under an employer-sponsored group health plan under subsection 1.
3. Treatment of employer-sponsored group health plan. If an individual is enrolled in an employer-sponsored group health plan as required under this section, the department shall treat coverage under the group health plan as the primary coverage and any medical assistance to which the individual or any dependents are entitled under this Title is secondary coverage.
4. Acceptance of cash, benefits or other consideration from employer. An individual eligible for or receiving medical assistance under this Title may not accept any cash, benefit or other consideration from an employer in return for not enrolling in the employer's group health plan.
5. No limit on medical assistance. This section may not be construed to limit the benefits for medical assistance available to an individual otherwise entitled to medical assistance under this Title.
SUMMARY
This bill provides that, as a condition of eligibility for MaineCare, individuals must apply for enrollment in an employer's group health plan. The bill makes clear that the employer's group health plan is the primary coverage and any MaineCare benefits are secondary.