Revised Supplemental Health Insurance Reporting Form

Bulletin 286A REVISED SUPPLEMENTAL HEALTH INSURANCE REPORTING FORM This bulletin replaces Bulletin 286, which required reporting of itemized health insurance premium written on three supplemental reporting forms. The Bureau will continue to require supplemental reporting due to the lack of detail of annual statement data to distinguish among various lines of health insurance with differing characteristics. There is now one combined form for use by all companies writing health insurance premium in Maine. Additional categories of coverage included in the combined report are credit, short-term medical, stop loss (employee benefit excess), and Federal employees health benefit plans. Reports are due annually on April 1. Reports may be filed either in hard copy or electronically. Forms in Microsoft Excel or Adobe PDF format can be downloaded from the Bureau's website or may be requested by sending an e-mail to Mary.M.Hooper@maine.gov. Reports may be filed by email to the same address. Date: 09-08-04 Alessandro A. Iuppa Superintendent of Insurance NOTE: This bulletin is intended solely for informational purposes. It is not intended to set forth legal rights, duties or privileges nor is it intended to provide legal advice. Readers are encouraged to consult applicable statutes and regulations and to contact the Bureau of Insurance if additional information is needed.