Maine Individual and Small Group Health Reinsurance

In May 2011, the Maine State Legislature passed Public Law Chapter 90 – An Act to Modify Rating Practices for Individual and Small Group Health Plans and to Encourage Value-based Purchasing of Health Care Services (PL90). Included in the many components of PL90 was the establishment of MGARA as a reinsurance program for the higher-risk segment of Maine’s individual health insurance market. The portion of PL90 establishing MGARA was codified at 24-A MRS c. 54-A and is referred to herein as the Enabling Act.

If you are an individual seeking insurance, please contact www.maine.gov/pfr/insurance.

Following a hiatus during the operation of a federal reinsurance program under the ACA, MGARA re-started its operations as of January 1, 2019, providing reinsurance for medical insurance plans and programs with initiation or renewal dates on or after January 1, 2019. The State of Maine received approval from the United States Department of Health & Human Services, Centers for Medicare & Medicaid Services, and the U.S. Department of the Treasury of its Application for State Innovation Waiver under Section 1332 of the Patient Protection and Affordable Care Act. Pursuant to that approval, MGARA re-initiated MGARA operations as of January 1, 2019. MGARA received approval from the U.S. Department of Health and Human Services and the U.S. Department of the Treasury by letter dated 7/15/22 that authorized the extension of the MGARA reinsurance program to a merged individual and small group market for plan years 2023 – 2027, as well as quarterly adjustments for small group plans that do not renew on a calendar year basis.