{"data":{"id":"us-me/24-a-m.r.s.-4334","jurisdiction":"us-me","citation":"24-A M.R.S. §4334","heading":"Substantial insurance risk; substantial enrollment risk","body":"1.  Substantial insurance risk.  Substantial insurance risk is risk based on the use or costs of referral services only, when the downstream entity is at risk for more than 25% of potential payments by the carrier to the downstream entity.\n2.  Substantial enrollment risk.  Substantial enrollment risk exists when a carrier enters into a risk arrangement with a downstream entity involving more than 25% of the enrollees served by the carrier in the State unless the risk arrangement is a risk-sharing arrangement.","path":["TITLE 24-A: MAINE INSURANCE CODE","CHAPTER 56-A: HEALTH PLAN IMPROVEMENT ACT","SUBCHAPTER 3: DOWNSTREAM RISK"],"source_url":"https://legislature.maine.gov/statutes/24-A/title24-Asec4334.html","current_through":"October 1, 2025","vintage":"","retrieved_at":"2026-09-04T15:12:33Z","sha256":"cde98ec012f18f07069b167dd3394486bdb8987e07f27962f32f456c6d493b47","source_id":"us-me","stale":false,"prev":"us-me/24-a-m.r.s.-4333","next":"us-me/24-a-m.r.s.-4335"},"notice":"GroundRules: Original legal text. Not legal advice."}