Delaware Health Insurance (DE)

Delaware (DE)
Individual Health Insurance Regulations

Learn more about Delaware Individual Health Insurance

Health insurance is mandatory to protect your family's health against unpredicted events of sickness or injury. Before opting for health coverage, you should go through your family's medical needs and your budget. Being a Delaware resident, you can choose from various health insurance alternatives. The Delaware Insurance Department supervises the legislature under which the Delaware health insurers can sell private health insurance to individuals and families.

Delaware health insurance companies are not required to provide guarantee issued coverage to the applicant. This means that they may accept or decline the applicants based on their 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. The state has not specified the time limit for the exclusion of pre-existing health conditions. However, the insurance companies can look back in your 60-month health history to decide whether or not you are already suffering from pre-existing conditions. As in most health insurance policies, Delaware health insurers provide individual and family health insurance based on your age, health status and lifestyle habits. The health plans usually vary from one health insurer to another.

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. to qualify for the group plan, the company must have two employees working for at least 6 months of the year and 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 35%.

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, a widow and the deceased member’s children. The insured would be responsible for premium payment of the coverage along with 2% administrative fees. Delaware does not have a state mini-COBRA regulation for companies with less than 20 employees.

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