18 Del. Admin. Code § 1308-4.0

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

Section 1308-4.0 - Establishment of classes of business

4.1 A small employer carrier that establishes more than one class of business pursuant to the provisions of 18 Del.C. § 7204 shall maintain on file for inspection by the Commissioner the following information with respect to each class of business so established:

4.1.1 A description of each criterion employed by the carrier (or any of its agents) for determining membership in the class of business;

4.1.2 A statement describing the justification for establishing the class as a separate class of business and documentation that the establishment of the class of business is intended to reflect substantial differences in expected claims experience or administrative costs related to the reasons set forth in 18 Del.C. § 7204; and

4.1.3 A statement disclosing which, if any, health benefit plans are currently available for purchase in the class and any significant limitations related to the purchase of such plans.

4.2 A carrier may not directly or indirectly use group size as a criterion for establishing eligibility for a health benefit plan or for a class of business.

18 Del. Admin. Code § 1308-4.0