Statutes, codes, and regulations
Delaware Administrative Code
Title 18 - InsuranceHealth Insurance Specific Provisions
Requirements for Fully Insured Multiple Employer Welfare Arrangements and Association Health Plans
Section 1405-10.0 - Notice Requirements

18 Del. Admin. Code § 1405-10.0

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Current through Register Vol. 28, No. 5, November 1, 2024
Section 1405-10.0 - Notice Requirements
10.1 No policy of health insurance or certificate under a policy offering health insurance shall be delivered or issued for delivery in this State until a copy of the form and of the rules for the classification of risks has been filed with and approved by the Commissioner in accordance with Section 4.0 of this regulation.
10.2 The following notice shall be provided by the insurer within the policy documents to employers and employees who obtain coverage from an association or MEWA:

"NOTICE

THE {Insert the name of the FULLY INSUREDASSOCIATION OR MULTIPLE EMPLOYER WELFARE ARRANGEMENT in all capital letters} IS NOT AN INSURANCE COMPANY. FOR ADDITIONAL INFORMATION ABOUT THE {Insert the name of the ASSOCIATION OR MULTIPLE EMPLOYER WELFARE ARRANGEMENT in all capital letters} YOU SHOULD ASK QUESTIONS OF THE ADMINISTRATOR OF THE {Insert the name of the ASSOCIATION OR MULTIPLE EMPLOYER WELFARE ARRANGEMENT in all capital letters}, OR YOU MAY CONTACT THE DELAWARE DEPARTMENT OF INSURANCE AT__________."

10.3 Each fully insured association or MEWA-related notice shall include the Department's current consumer service telephone number and website in the blank provided in this notice.
10.4 The insurer of a fully insured plan shall include in its policy documents the following disclosures:
10.4.1 The Delaware resident has the option of purchasing insurance on the Delaware Health Insurance Marketplace;
10.4.2 Purchasing a fully insured association or MEWA health benefit plan may prevent the employer or individual from accessing premium subsidies and cost sharing reductions that may otherwise be available under the Patient Protection and Affordable Care Act; and
10.4.3 Purchasing a fully insured association or MEWA health benefit plan may be more expensive than purchasing a plan on the Delaware Health Exchange.
10.5 The insurer shall file its advertising and marketing materials with the Commissioner for prior approval.
10.6 The insurer shall file policies, certificates, statement of benefits, brochures, and any other endorsement, rider, or application used in conjunction with the health benefit plan with the Department for prior approval.

18 Del. Admin. Code § 1405-10.0

22 DE Reg. 509 (12/1/2018) (Final)