18 Del. Admin. Code § 1308-11.0

Current through Register Vol. 28, No. 5, November 1, 2024

Section 1308-11.0 - Restrictive riders

11.1 A restrictive rider, endorsement or other provision that would violate the provisions of 18 Del.C. § 7207 (c)(5)(b) and that was in force on the effective date of this Regulation may not remain in force beyond the first anniversary date of the health benefit plan subject to the restrictive provision that follows the effective date of this Regulation. A small employer carrier shall provide written notice to those small employers whose coverage will be changed pursuant to this subsection at least thirty (30) days prior to the required change to the health benefit plan.

11.2 Except as permitted in 18 Del.C. § 7207 (c)(2), a small employer carrier shall not modify or restrict a basic or standard health benefit plan in any manner for the purposes of restricting or excluding coverage or benefits for specific diseases, medical conditions or services otherwise covered by the plan.

11.3 Except as permitted in 18 Del.C. § 7207 (c)(2), a small employer carrier shall not modify or restrict any health benefit plan with respect to any eligible employee or dependent, through riders, endorsements or otherwise, for the purpose of restricting or excluding coverage or benefits for specific diseases, medical conditions or services otherwise covered by the plan.

18 Del. Admin. Code § 1308-11.0