ME| The State of Maine Bureau of Insurance Bulletin 485 outlines a comprehensive set of new legislative and regulatory changes enacted during the First Regular Session of the 132nd Legislature, which will impact health insurance, property & casualty insurance, and general insurance matters. These changes, effective primarily from September 24, 2025, address a broad range of policy issues—spanning coverage requirements, pharmacy benefits, claims processes, producer licensing, and storm resiliency measures.
Regulatory Changes by Category:
Health Insurance:
- Coverage for Step Therapy for Metastatic Cancer
- Access to Nonformulary Drugs and Drugs for Serious Mental Illness
- Increased Access to HIV Prevention Medications
- Coverage for Nonprescription Oral Hormonal and Emergency Contraceptives
- Coverage for Dental Services by Licensed Dental Hygienists
- Rights to Audit Claims Payments and Disclose High-Cost Claims
- Amendments to Rule 850: Health Plan Accountability
- Fair Pharmacy Reimbursement Practices
- Protections for 340B Program Participants
- Expansion of Direct Health Care Service Arrangements to Specialists
- Alternative Claims Payment Methods for Dental Care Providers
- Required Disclosure of Health Care Provider Contract Negotiator Information
- Dental Plan Prohibition on Fees for Uncovered Services
- Prohibition of PBM Spread Pricing (with sunset)
- Exemption for Certain Large Group Plans from Preventive Visit Cost Sharing
Property and Casualty Insurance:
- Storm Preparedness Grants under the HoME Resiliency Program
- Medical Payments Coverage Assignments Process
- Intrastate Commercial Motor Vehicle Insurance Requirements
General Insurance Matters:
- Corrections and Updates to the Insurance Code
- Establishment of an Apprentice Insurance Producer License
- Authorization for Funeral Practitioners to Sell Pre-need Insurance
- Workers’ Compensation Self-insurers Requirements Amendments
- Preferential Treatment for Federal Home Loan Bank-Backed Insurer Loans
- Repeal of Fronting Arrangements for Group Self-Insurers