Preferred Provider Arrangements

The Maine Bureau of Insurance provides on this page all of the information necessary to register a Preferred Provider Arrangement. Contact Us if you have questions or are unable to find what you are looking for.

For PPO Initial and Annual registrations effective in 2020, applications must be filed in paper format, PDF/Zip File, or thumbdrive.  Please include a cover letter identifying and explaining any changes in the application for the year.  Applications must be fully completed and include the financials or provide a timeframe for receipt of financials.

Important Notice:  Starting 2023, renewal notices will be emailed.  Please contact Violet Hyatt at violet.m.hyatt@maine.gov to update your contact information by 12/31/22.

Initial Registration

• Preferred Provider Arrangement Initial Registration Form (PDF)

Annual Registration

• Maine Bureau of Insurance Preferred Provider Arrangement Annual Registration Form (PDF)

Annual Reporting Requirements

• Health Report Card Survey
• Any Willing Pharmacy (Bulletin 377)

Fees

• Company Renewal Dates and Fees (PDF)
• Fee Schedule - (Scroll to Item 20)
• Authorization of Credit Card Payment (PDF)

Requesting Confidential Treatment of Documents

• Instructions for Requesting Confidential Treatment of Documents with the Bureau of Insurance

Statutory Requirements

• Title 24-A M.R.S.A. Chapter 32 (Preferred Provider Arrangement Act)
• Title 24-A M.R.S.A Chapter 56-A (Health Plan Improvement Act)
• Rule Chapter 360 (DOC) (Requirements Applicable to Preferred Provider Arrangements)
• Rule Chapter 850 (DOC) (Health Plan Accountability)

The documents on this page are also available in hard copy by contacting the Bureau.