{"data":{"id":"us-me/24-a-m.r.s.-4261","jurisdiction":"us-me","citation":"24-A M.R.S. §4261","heading":"Fees for covered dental services","body":"1.  Definitions.  As used in this section, unless the context otherwise indicates, the following terms have the following meanings.\nA.  \"Covered dental service\" means a dental service for which reimbursement is available under an individual or group contract or for which reimbursement would be available but for the application of contractual limitations such as a deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation, alternative benefit payment or any other similar limitation.\nB.  \"Dental provider\" means a person licensed under Title 32, chapter 143, subchapter 3.\n2.  Prohibition of required fees for dental services not covered.  A health maintenance organization that issues individual or group dental insurance or individual or group contracts that include coverage for dental services may not require, directly or indirectly, that a participating dental provider provide dental services at a fee set by, or subject to the approval of, the health maintenance organization for a service that is not a covered dental service.\n3.  Fees for covered dental services.  A fee for a covered dental service must be set by the health maintenance organization in good faith and may not be nominal.","path":["TITLE 24-A: MAINE INSURANCE CODE","CHAPTER 56: HEALTH MAINTENANCE ORGANIZATIONS"],"source_url":"https://legislature.maine.gov/statutes/24-A/title24-Asec4261.html","current_through":"October 1, 2025","vintage":"","retrieved_at":"2026-09-04T15:12:33Z","sha256":"3b0efab020ceac851bb8cf3d7f2d5bed6bf366509dc8e072b1f9152becb442b9","source_id":"us-me","stale":false,"prev":"us-me/24-a-m.r.s.-4260","next":"us-me/24-a-m.r.s.-4301"},"notice":"GroundRules: Original legal text. Not legal advice."}