Current through 2024 Legislative Session Act Chapter 531
Section 3571M - Comprehensive health insurance coverage [For application of this section, see 79 Del. Laws, c. 99, Section 19](a) Coverage for essential health benefits package. - A health insurer that offers health insurance coverage in the small group market shall ensure that such coverage includes the essential health benefits package in conformity with § 1302 of the Patient Protection and Affordable Care Act [ 42 U.S.C. § 18022 ], as the law and its implementing regulations were in effect on January 1, 2018, and state law. The Commissioner shall issue a regulation setting forth what constitutes "essential health benefits" for purposes of this section.(b) Cost-sharing under group health plans. - A group health plan shall ensure that any annual cost-sharing imposed under the plan does not exceed the limitations provided for under § 1302(c)(1) and (2) of the Patient Protection and Affordable Care Act [ 42 U.S.C. § 18022(c)(1) and (2) ], as the law and its implementing regulations were in effect on January 1, 2018, and state law.(c) Child-only plans. - If a health insurer offers health insurance coverage in any level of coverage specified under § 1302(d) of the Patient Protection and Affordable Care Act [ 42 U.S.C. § 18022(d) ], as the law and its implementing regulations were in effect on January 1, 2018, or state law, the health insurer shall also offer such coverage in that level as a plan in which the only enrollees are individuals who, as of the beginning of the plan year, are under the age of 21.(d) Dental only. - This section shall not apply to a plan described in § 1311(d)(2)(B)(ii) of the Patient Protection and Affordable Care Act [ 42 U.S.C. § 18031(d)(2)(B)(ii) ], as the law and its implementing regulations were in effect on January 1, 2018.Amended by Laws 2019, ch. 186,s 7, eff. 8/6/2019.Amended by Laws 2017, ch. 79,s 30, eff. 7/17/2017.Added by Laws 2013, ch. 99,s 8, eff. 7/15/2013.