Maine Community Health Options

“Explanation: this corporation has one class of members consisting of all individuals covered under health insurance policies issued by the corporation.”

“Explanation: each member 18 years and older shall have a single vote. All decisions of the members shall be by a majority vote. The members shall be listed on a schedule that shall be maintained with this corporation's other books and records. The members shall have the sole and exclusive power and authority: to amend this corporation's articles of incorporation; to elect or remove directors of this corporation; and to approve the merger, consolidation, dissolution, or sale of all or substantially all of the assets of this corporation.”

“Explanation: each member 18 years and older shall have a single vote. All decisions of the members shall be by a majority vote. The members shall be listed on a schedule that shall be maintained with this corporation's other books and records. The members shall have the sole and exclusive power and authority: to amend this corporation's articles of incorporation; to elect or remove directors of this corporation; and to approve the merger, consolidation, dissolution, or sale of all or substantially all of the assets of this corporation.”

“Explanation: a copy of the form 990 is provided to board members for review and approval prior to filing.”

“Explanation: when officers and board members start, they are required to sign a conflict of interest statement and reporting form indicating that they do not have any conflicts of interest or any potential conflicts of interest. Any potential conflict of interest is reviewed by the compliance department and outside counsel, if necessary, to determine if such conflict would prohibit the individual from performing their officer or board duties. They are then required to recertify annually.”

“Explanation: numerous levels of oversight were involved in setting both ceo and officers' compensation for maine community health options. First and foremost, the formation board of mcho was critically involved in the decision about the compensation of the ceo. Salaries of ceos of other non-profit insurance organizations were provided to the board and the ceo salary was approved. Once approved by the board, cms reviewed the salary for reasonableness and adequate comparability prior to execution of the letter of agreement. On an annual basis, compensation changes for the ceo are recommended by human resources utilizing various market compensation tools. Any compensation changes are discussed and ultimately approved by the executive committee of the board of directors. To determine salaries for the remaining officers of mcho, the ceo and the vice president, human resources utilized various market compensation tools to determine comparable salaries based on what would be paid for services performed by an officer for like enterprises under like circumstances. When an officer subsequently leaves their position, the salary of the newly hired individual is determined by human resources and the ceo utilizing varous market compensation tools. All compensation decisions are documented.”

“Explanation: mcho will make its governing documents and conflict of interest policies available to the public in print upon request. Mcho's financial statements are made public with the maine bureau of insurance and the national association of insurance commissioners as well as through form 990.”

“The organization was established and operates as a consumer-operated and oriented plan ("co-op") in accordance with the provisions of section 1322 of the patient protection and affordable care act. As a consumer-governed nonprofit health insurance issuer, the organization: (1) partners with members, businesses, and health professionals to provide affordable, high-quality benefits that promote health and wellbeing, (2) creates and develops innovative forms of healthcare delivery for the purpose of creating better healthcare value through improved health outcomes at lower cost, and (3) promotes the health of the people of maine and educates the public about health, healthcare, and related topics. Form 990, part v, line 13: mcho is licensed to issue qualified health plans in the following states: me, nh mcho maintains and reports the full amount of reserves required by maine and new hampshire state law of $100,000 and $0, respectively.”

“Change in nonadmitted assets -1,157,968. Increase in reserves for accidents/health contracts -10,760,226.”

“Maine community health options prepared its 2024 audited financial statements using the statutory basis, which is a comprehensive method other than u.s. Generally accepted accounting principles (gaap).”

“Explanation: this process has not changed from the prior year.”