Del. Code tit. 29 § 5203

Current through 2024 Legislative Session Act Chapter 269
Section 5203 - [See Note] Specifications of the coverage
(a) The basic health care insurance plan for state employees shall be equivalent to the "minimum creditable coverage" as defined by applicable federal law and include coverage for contraceptive methods under § 5203A of this chapter.
(b) The plan shall be for regular employees and eligible pensioners under 65 years of age and for employees and eligible pensioners over 65 years of age who are not entitled to services, rights or benefits under the federal Medicare Program (U.S. Public Law 89-97, as amended) [ 42 U.S.C. § 1395 et seq.]; and a plan which is supplemental to Medicare parts A and B, or constructed as a plan under Medicare part C, for eligible pensioners entitled to services, rights or benefits under the federal Medicare Program.
(c)
(1) The basic plan must provide coverage for chronic care management and primary care and coverage at a reimbursement rate that is not less than the Medicare reimbursement for comparable physician services.
(2) Coverage for chronic care management must not be subject to patient deductibles, copayments, or fees.
(3) If a comparable Medicare reimbursement rate is not available, a plan shall reimburse for services at the rates generally available under Medicare for services such as office visits and prolonged preventive services, which may be further delineated by regulation.
(d) The plan may not place any annual or lifetime numerical limitations on physical therapy or chiropractic care visits for the purpose of treating back pain.

29 Del. C. § 5203

Amended by Laws 2017, ch. 430,s 4, eff. 10 days following the date of publication in the Register of Regulations of a notice that both of the following have occurred: (1) Funds have been appropriated to implement the provisions of this Act. (2) The Director of the Office of Management and Budget has provided notice to the Registrar of Regulations that the contingency in (1) has been fulfilled..
Amended by Laws 2017, ch. 392,s 8, eff. 1/1/2019.
Amended by Laws 2017, ch. 323,s 3, eff. 7/11/2018.
29 Del. C. 1953, § 5203; 57 Del. Laws, c. 319; 57 Del. Laws, c. 350; 69 Del. Laws, c. 64, §66; 72 Del. Laws, c. 204, § 4; 78 Del. Laws, c. 14, §§ 6, 7.;
This section is set out two times. See also Del. C. § 5203, effective until contingency satisfied.