18 Del. Admin. Code § 1402-5.0

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

Section 1402-5.0 - Requirements; Notice Of Availability Of Alternative Dental Plan Coverage

5.1 All employers and organizations shall offer their employees, and eligible dependents' and members and members' eligible dependents at the time an HMO-type dental plan is offered or renewed, an alternative plan which permits covered persons to obtain dental services from any licensed dentist. Each employer shall pay or contribute toward the provision of an alternative dental plan an amount equal to the premium or cost which it pays or contributes to the HMO-type dental plan contract.

5.2 Each employer or organization covered by this interim regulation, after the effective date of this regulation and at least 30 days prior to the offer or renewal of a dental plan, shall notify their employees or members of their right to select alternative dental plan coverage. This notice shall be in substantially the following form:

5.3 "Legislation adopted by the General Assembly of the State of Delaware requires that all employers and organizations providing an HMO-type dental plan for their employees or members which restricts the choice of dentists also must offer an alternative plan which allows participants to choose the dentist of their choice. An employer or organization must contribute to the alternative dental plan an amount equal to the contribution to the HMO-type dental plan.

5.4 Please contact [insert name of proper department or person] if you want to learn more about the alternative dental plan coverage."

18 Del. Admin. Code § 1402-5.0