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Delaware General AssemblyDelaware RegulationsMonthly Register of RegulationsNovember 2018

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(18 Del.C. §§311 & 1720; 18 Del.C. Chs. 33, 35 & 36; 29 Del.C. §10119 & in response to 26 CFR 54.9833-1, 29 CFR 2590.736, 45 CFR 146.125 and 45 CFR 148.120)
Pursuant to 29 Del.C. §10119, it is necessary to adopt new Regulation 1320, Minimum Standards for Short-Term, Limited Duration Health Insurance Plans.
E. On August 3, 2018, the federal government issued a rule that will apply to STLD health insurance policies sold on or after October 2, 2018. See 83 Fed. Reg. 38212 (the Final Rule). The Final Rule would extend the period during which plans can be sold from three to 12 months and would allow for consecutive renewal of short-term policies. The relaxation in renewal requirements allows consumers to enroll in the policies for a period arguably longer than "short term" and may re-enroll in the policies for an indefinite period of time.
G. The Final Rule expressly describes short-term coverage as "a type of health insurance coverage that was primarily designed to fill temporary gaps in coverage that may occur when an individual is transitioning from one plan or coverage to another plan or coverage (emphasis added)." Id. at 38213.
2. This order shall be effective for 120 days (until March 31, 2019), or until the proposed new Regulation 1320 published elsewhere in this edition of the Register of Regulations is adopted pursuant to the Delaware Administrative Procedures Act, whichever shall first occur. See 29 Del.C. § 10119(3).
IT IS SO ORDERED this 15th day of October, 2018.
This regulation is issued pursuant to the authority vested in the Commissioner pursuant to 18 Del.C. §311, 18 Del.C. §1720,18 Del.C. Chs. 33, 35 and 36, 29 Del.C. Ch. 101 and in response to 26 CFR 54.9833-1, 29 CFR 2590.736, 45 CFR 146.125 and 45 CFR 148.120.
"Carrier" means any entity that provides health insurance in this State. Carrier includes an insurance company, health service corporation, managed care organization and any other entity providing a plan of health insurance or health benefits subject to State insurance regulation. Carrier also includes any third-party administrator or other entity that adjusts, administers or settles claims in connection with health insurance.
"Certificate" means a statement of the coverage and provisions of a policy of either individual or group accident and sickness insurance, which has been delivered or issued for delivery in this state and includes riders, endorsements and enrollment forms, if attached to the policy.
"Commissioner" means the Delaware Insurance Commissioner.
"Direct response solicitation" means a communication through a sponsoring or endorsing entity or individually through mail, telephone, the internet or other mass communication media.
"Health care services" means any services or supplies included in the furnishing to any individual of medical care, or hospitalization or incidental to the furnishing of such care or hospitalization, as well as the furnishing to any individual of any and all other services for the purpose of preventing, alleviating, curing or healing human illness, injury, disability or disease.
"Short-term, limited duration health insurance" means health insurance coverage provided pursuant to a contract with a health carrier that has an expiration date specified in the contract that is less than or equal to 3 months after the original effective date of the contract and has a duration of no longer than 3 months in total.
This coverage is NOT required to comply with certain federal market requirements for health insurance, principally those contained in the AFFORDABLE CARE ACT.
Be sure to check your policy carefully to make sure you are aware of any EXCLUSIONS or LIMITATIONS regarding coverage of PREEXISTING CONDITIONS or HEALTH BENEFITS (such as hospitalization, emergency services, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services).
Be sure to check your policy carefully to make sure you are aware of any LIFETIME and/or ANNUAL DOLLAR LIMITS on health benefits.
If this coverage expires or you lose eligibility for this coverage, YOU MIGHT HAVE TO WAIT until an open enrollment period to get other health insurance coverage.
This coverage is NOT "MINIMUM ESSENTIAL COVERAGE." If you don't have minimum essential coverage for any month in 2018, you may have to make a payment when you file your tax return unless you qualify for an exemption from the requirement that you have health coverage for that month.
This coverage is NOT required to comply with certain federal market requirements for health insurance, principally those contained in the AFFORDABLE CARE ACT.
Be sure to check your policy carefully to make sure you are aware of any EXCLUSIONS or LIMITATIONS regarding coverage of PREEXISTING CONDITIONS or HEALTH BENEFITS (such as hospitalization, emergency services, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services).
Be sure to check your policy carefully to make sure you are aware of any LIFETIME and/or ANNUAL DOLLAR LIMITS on health benefits.
If this coverage expires or you lose eligibility for this coverage, YOU MIGHT HAVE TO WAIT until an open enrollment period to get other health insurance coverage.
This coverage is NOT "MINIMUM ESSENTIAL COVERAGE." If you don't have minimum essential coverage for any month in 2019 or thereafter and the penalty for not having minimum essential coverage is more than the 2018 amount of $0, you may have to make a payment when you file your tax return unless you qualify for an exemption from the requirement that you have health coverage for that month.
This regulation shall take effect on December 1, 2018 and shall remain effective for 120 days, until March 31, 2019, or until readopted pursuant to the Administrative Procedures Act.
Last Updated: December 31 1969 19:00:00.
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