ME Insurance Bulletin 292
Reporting Forms for Mandated Benefits
Bulletin 292
REPORTING FORMS FOR MANDATED BENEFITS
The Bureau of Insurance is replacing the forms used to report benefits for (a) Mental Health,
Alcoholism and Drug Dependency Treatment, (b) Chiropractic Services, and (c) Mammography
Screening as prescribed by Bulletins 160 and 172 and Regulation 600. The report is due annually by
April 30 of the following year.
This report provides the same information as the other three but is one form and it can be sent the
Bureau by e-mail. All companies writing group or individual medical insurance in Maine should keep
this form on file. Those companies with no medical insurance in force in Maine need not report.
Companies may use the older forms for reporting year 2000 data but are encouraged to use this form.
Thereafter this form will be the only one used.
Companies are encouraged to report electronically but may provide hard copy. Forms in Microsoft
Excel format can be downloaded from the Bureau web site at
http://www.maine.gov/pfr/insurance/licensees/insurance-companies/insurers/data-reportingrequirements or may be requested by sending an e-mail to Keith.A.Fougere@maine.gov.
Reports may be filed by e-mail to the same address.
January 11, 2001 _________________________________
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.