God man... protect us from ourselves.. Foolish legislation this. Caping profits on a business is insane. ... the few remaining health insurance companies still here in Maine will join the others that left because of state policies that were put in place twelve years ago when Mr Goode was in middle school. Maybe thats the plan. If all the private insurance carriers leave then the "State" will have to step in and take over through thier costly Dirigo program. That program cost about $20,000 per insured person. Certainly not the astouding savings that you say there is. As for transparency. The details of all insurance plans and thier benefits are already filed in Augusta. The person who later found out thier deductable was $10,000 per person was a fool who didnt bother to read the information handed to him/her. You can lead the stupid to the phamplet but you cant make them read. How would the changes you advocate change her IQ points and reading ability. Every policy I have ever gotten over the decades has come with disclosures describing details. This is merely a smoke screen for what Mr. Goode really wants ...total control of health Insurance. This is only one more piece of legislation aimed at reducing choices and increasing government control.

The last time I was enrolled in an insurance plan through work, I chose a plan that covered 100% of certain medical costs. After going through a procedure, I was surprised to get a bill for something that was supposedly covered 100%. When I contacted the insurance company, I was told they covered 100% of what they concidered reasonable not what the actual bill was for. I could not find this statement anywhere in my policy. Concidering my choices were limited to a doctor in their network, it's not like I could go shopping around for the cheapest.

Wolfie, It sounds like you had a HMO. Generally insurance companies negotiate with doctors and hospitals for the price of a procedure. It is often lower than the providers real charges are because it is negotiated that way. Hospitals ,because of thier billing methods, will often send out a bill for the difference. This happened to me as well... I sent the payment and six weeks later I recieved a refund check in the mail. This is not an insurance problem it is a hospital billing problem. If your provider charged you more than 100% of the negotiated price you need to remind them of the negotiated price. They should write it off. This legislation Mr Goode advocates would not address that problem.

Keep up the good work, Adam Goode! I hope Helen Hanson was refunded all the premiums she paid into that bogus policy. We heard her story in an earlier BDN on this subject, published Jan. 16th. I am re-posting a comment I made then:

This bill is very much needed in this state, where fake insurers lurk around every corner trying to sell "affordable" health insurance. Remember this story? "Friday, April 4, 2008 -- AUGUSTA (AP) - Maine state officials say MEGA Life and Health Insurance Company, accused of improperly determining premiums for individual health insurance policies, has agreed to pay a $1 million fine and to refund $4.6 million, plus interest, to consumers. The penalties were announced Thursday by the Maine Bureau of Insurance and the Maine Attorney General's Office. Maine Insurance Superintendent Mila Kofman said the settlement carries one of the largest fines and amount of consumer restitution agreed to in Maine." MEGA is a classic example of a fake insurer. Don't let them rip you off! There is no affordable health insurance in Maine.

MEGA's salesman met with me over lunch and regaled me for over three hours on the virtues of his policy. When the meeting was winding up and I said I would have to go home and discuss it with my husband -- the policy would cost $680 or so a month -- the salesman became very dismayed and said that would be tremendously inconvenient, he had traveled all the way there and taken so much time, etc., so I stupidly wrote out a check. Then when I got home and was read the riot act by my husband for doing this, I googled "Mega Life and Health Insurance Company" with the word "fraud" and got 13,000 hits. Fortunately I was able to stop the check.

There goes ol' Adam trying to live up to his name by doing goode. Vichet is right. Insurance companies are the backbone of our society. Since they exist to generate maximum profits for their shareholders, it's un-American to try and limit those profits. We wouldn't regulate banks or the CEOs of Wall Street firms, so why should we place limits on insurance company profits? The more money they make off of their customers, the larger their managers' bonuses and the more they have to spend on yachts and corporate jets. Those boats and planes are made by working people, who get sometimes $10 or more an hour for their labors. So we're all in this together: a rising tide lifts all yachts and jets. Transparency is the curse of all capitalist endeavors. It imposes rules that force fair competition, which in turn compels companies to waste their resources trying to beat the other guy. Leave them in the dark to do what they do best, unobserved. Three cheers for Vichet, and boo for do-gooder Adam!

Do I have this straight? Say the child is in a car accident, incurring $40,000 in bills, and the family has a $10,000 per person deductible. That means that the family has to pay $30,000 on the kid's bills, because there are three people in the family?

As for the title of this article. Yes I know what it covers. Yes I am sure.

No Rufus! The policy would cover the $30,000 after the injured child's $10,000 deductible because it is per person (that is if they deem the remaining charges "reasonable and customary"). But if anyone else in the family needs health care, each member would have to rack up $10,000+ EACH in charges before anything is covered. And that's per year or per policy period, of course, which means if the injured child needs care in the next year or period the family would be on the hook for his first $10,000 in costs, etc. THEN most policies have a maximum payout per person, so they have to be sure they know what that is also so they're aware when they're about to exceed it, etc. But, your hypothetical family of three would be in big trouble if they were all in a care accident and each needed $9,999 in care -- they would have to pay out the full amount of $29,997 and wouldn't see a dime from the insurance company unless additional costs were incurred within the policy period.

Right on people do not read the information given to them. Nor, do the pay attention when they are told about what is going to happen. If rep Goode can out law naivete, stupidity or indifference in Augusta good luck. Big question now should be why would an insurance company send a benefit recipient to Massachusetts for procedures. Why cheap enough to pay for the procedure and travel expenses. Also if we good get rid of naivete by law we would probably loose half of our legislature.