Delaware (DE)
Individual Health Insurance Regulations

Learn more about Delware Individual Health Insurance

Delaware health insurance are not required to guarantee coverage to any of their health plans on a guaranteed issue basis. This means that they may accept or decline whomever they desire based on health history or current health status. Furthermore, there are no rate caps imposed on insurance companies offering individual health plans in the state. Creditable coverage need only be offered to persons that are HIPAA eligible and have been covered under a group health plan for at least 18 months that did not expire within the past 63 days. For those that are not HIPAA eligible, the insurance companies may place exclusions on the issuance of the policy that exempts them from paying benefits on any disclosed pre-existing medical condition.

Request Delaware Individual Health Insurance Quotes from any of our multiple providers.

Delaware (DE)
Small Group Health Insurance Regulations

For health insurance purposes, a small group can range from 1 to 50 employees. Companies with between 2 and 50 employees are entitled to receive "guaranteed issue" health insurance. This means that they can't be denied coverage, regardless of the overall health status or history of the employees that they wish to include on the group plan. Income tax documentation from the previous quarter may be required from the insurance company to verify which employees are eligible for coverage. This is typically any employee that worked a minimum of 20 hours per week. In addition, over half of the eligible employees must reside within the state of Delaware. A self-employed business owner may be able to obtain group health insurance in Delaware, but is subject to medical review. If they meet the medical guidelines of the insurance carrier, they may select any health plan that is available to larger groups. If they do not meet medical review, they will be offered a selection of a couple of plans that are offered on a "guaranteed issue" basis to one man groups. Enrollment in a one man group health plan may also be subject to bi-annual enrollment periods. Depending on the size of the group, insurance companies may adjust the standard published premium up by as much as 25%.

Small business owners can request quotes for Delaware group health insurance from any of our listed providers.

Delaware COBRA and Continuation Coverage

Groups of more than 20 insured employees must follow federal COBRA guidelines which allow any employee to remain on the group health plan for 18 months after leaving employment with the company, regardless of the reason they are leaving. In some cases, a person may be eligible to remain on COBRA for 36 months. This includes person that meet disability guidelines. Groups of 2-19 insured persons are subject to Delaware mini-COBRA laws. Under state law, small groups must follow the same federal guidelines imposed on larger group health plans. The only exception is that small groups are only required to permit disabled persons to remain on COBRA for 29 months. Once a person has exhausted their COBRA coverage, they may be eligible to be guaranteed health insurance coverage under the Delaware Health Reinsurance Association, which is the state's risk pool program.