Individual Health Insurance Minimum Standards

What this document is

Delaware Code Title 18 Chapter 36 - Individual Health Insurance Minimum Standards (Secs. 3601-3608) is a state statute published by Delaware Code Online (delcode.delaware.gov), Delaware General Assembly. It is one of the Delaware documents that insurance license exam questions are written from, including delaware life & health practice questions. This page summarizes it and points to the official version, which is the text to rely on.

Sections cited in practice questions

Each practice answer shows the exact passage it comes from. These are sections of this document that questions cite, with a short excerpt from the source text.

• 18 Del. C. Chapter 36 § 3601(a) (Purpose and scope)

  “Additionally, the purpose of this chapter is to promote the availability of health insurance coverage to recently uninsured individuals, regardless of their health status or claims experience, and to improve the overall fairness and efficiency of the individual health insurance market.”

• 18 Del. C. Chapter 36 § 3604(a)-(b) (Minimum Standards for Benefits: Categories of Coverage and Combination Policies)

  “(1) Basic hospital expense coverage; (2) Basic medical-surgical expense coverage; (3) Hospital confinement indemnity coverage; (4) Major medical expense coverage; (5) Disability income protection coverage; (6) Accident only coverage; (7) Specified disease or specified accident coverage; and (8)...”

• 18 Del. C. Chapter 36 § 3603(c) (Standards for policy provisions)

  “The Commissioner may issue reasonable regulations that specify prohibited policies or policy provisions not otherwise specifically authorized by statute which in the opinion of the Commissioner, are unjust, unfair or unfairly discriminatory to the policyholder, any person insured under the policy or beneficiary.”

• 18 Del. C. Chapter 36 § 3608(b) (Renewability of Coverage: Bar on New Business After Market Exit)

  “An individual carrier that elects not to renew all its health benefit plans under paragraph (a)(4) of this section shall be prohibited from writing new business in the individual market in this State for a period of 5 years from the date of the discontinuation of the last health benefit plan not so renewed.”

• 18 Del. C. Chapter 36 § 3604(d) (Commissioner Prescribes Method of Policy Identification)

  “(d) The Commissioner shall prescribe the method of identification of policies and contracts based upon coverages provided.”

• 18 Del. C. Chapter 36 § 3601(b) (Purpose and scope)

  “This chapter notwithstanding, Medicare supplement coverage shall be governed by Chapter 34, Medicare Supplement Insurance Minimum Standards, of this title.”

• 18 Del. C. Chapter 36 § 3605(c) (Disclosure Requirements: Status of the Outline of Coverage)

  “(c) The outline of coverage shall not be considered to be part of the policy or subscriber contract for insurance.”

• 18 Del. C. Chapter 36 § 3604(c) (Minimum standards for benefits)

  “(a) The Commissioner may issue regulations to establish minimum standards for benefits under each of the following categories of coverage in individual policies, other than conversion policies issued pursuant to a contractual conversion privilege under group or individual policy, when such group or...”

• 18 Del. C. Chapter 36 § 3605(d) (Written Disclosure of Declination of Coverage)

  “Every insurer or health service corporation electing to refuse coverage of an applicant or decline coverage of an insured who is not included within the coverage of Chapter 23 of Title 19 shall disclose to such applicant or insured in writing the fact of such noncoverage or declination of coverage....”

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