Maine Long-Term Care Report Instructions
The Maine Long-Term Care Report is required under 24-A M.R.S.A. §§ 5071-5083 and Rule
Chapter 425 (see Ch.425). The report is due annually on June 30
th
for the preceding calendar
year.
All companies that are licensed for Health authority in Maine must complete the report at
https://www.maine.gov/pfr/insurance/licensees/insurance-companies/insurers/data-
reporting-requirements. Scroll to Long-Term Care Insurance Reporting (Rule 425).
Important: The following information is required. If any fields are left blank, your report will
not load into our database and will be returned for completion.
To avoid file corruption and possible load failure
*OPEN A FRESH REPORT FORM FOR USE WITH EACH COMPANY. *
Section I. Company Information
Company Name and NAIC Code.
Section II. Contact Information
First Name, Last Name, E-mail, and Phone Number of the individual responsible for completing
the report.
Section III. Lapsed long-Term Care Insurance Policies
Number of lapsed policies, for Maine only, as of the end of the preceding calendar year, listed
on the report form.
Section IV. Information about Long-Term Care Insurance Claim Denials by Class of Business
• Report information for Maine only.
• Values entered in Section IV must be whole numbers greater than or equal to zero.
• The Number of Claims Denied must be less than or equal to the Number of Long-Term
Care Insurance Claims.
• Values for cells in gray are calculated and you may not enter values there.
Definitions:
Classes of Business means Individual policies or Group policies.
Denied claim means the insurer refused to pay a claim for any reason other than for failure to
meet the waiting period or because of an applicable pre-existing condition.
First Level Review means the Standard Appeal as outlined in Rule 425 § 32(C). The insured
may appeal the claims denial by sending a written request to the insurer within 120 days after
receipt of the claim denial along with any additional supporting information.
Second Level Review means the second level review is outlined in Rule 425 (see Ch. 425) §
32(D). An insurer shall provide a second level appeal process to an insured who is dissatisfied
with a first level review determination under Subsection C.
Questions
If you have questions about the report form, contact Pamela.[email protected] or call her at
(207) 624-8458.
How to Submit Your Completed Report
Save your completed report form with your company name at the beginning of the file name.
We store received reports alphabetically by year. Please do not use acronyms. Send it by e-
mail to [email protected].
Encrypted E-Mail
Please do not use encrypted e-mail. We do not accept e-mails that require us to establish
accounts with usernames and passwords to receive reports. If this is an issue, please contact
[email protected] or call (207)-624-8440 to discuss other possibilities.
General E-Mail Addresses
Consider using an e-mail address that will always be received by someone on your staff (e.g.,
company, our notices are not undelivered.
