reglab/statecodes huggingface dataset:
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter II. Sponsored Captive Insurance Companies › § 6937. Investments by sponsored captive insurance companies.

§ 6937. Investments by sponsored captive insurance companies.
(a) Notwithstanding the provisions of § 6934 of this title, a sponsored captive insurance company may combine the assets of 2 or more protected cells for purposes of investing those assets. Such a combination of assets may not be construed as defeating the segregation of assets for purposes of §§ 6934 and 6938 of this title, or for accounting or other purposes. Sponsored captive insurance companies must comply with:
(1) The investment requirements contained in Chapter 13 of this title, as applicable; or
(2) Investment requirements as may be approved by the Commissioner upon application by a sponsored captive insurance company; or
(3) In the case of a sponsored captive insurance company that is also a special purpose financial captive insurance company, the investment requirements contained in § 6910(b) of this title.
(b) Compliance with the investment requirements set forth in paragraphs (a)(1) and (a)(2) of this section must be waived for sponsored captive insurance companies to the extent that credit for reinsurance ceded to reinsurers is allowed pursuant to § 6911 of this title or to the extent otherwise considered reasonable and appropriate by the Commissioner.
75 Del. Laws, c. 150, §  1;  76 Del. Laws, c. 161, §  13;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter II. Sponsored Captive Insurance Companies › § 6938. Delinquency of sponsored captive insurance companies.

§ 6938. Delinquency of sponsored captive insurance companies.
The provisions of § 6918 of this title shall apply to a sponsored captive insurance company and to each protected cell of the sponsored captive insurance company, provided:
(1) The assets of a protected cell may not be used to pay any expenses or claims other than those attributable to such protected cell; and
(2) The minimum capital and surplus of the sponsored captive insurance company shall at all times be available to pay any expenses of or claims against the sponsored captive insurance company.
75 Del. Laws, c. 150, §  1;  77 Del. Laws, c. 252, §  12;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter III. Special Purpose Financial Captive Insurance Companies › § 6951. Purpose.

§ 6951. Purpose.
This subchapter provides for the authorization of special purpose financial captive insurance companies empowered to issue securities and otherwise access financial markets and alternative sources of capital through securitizations and other transactions. The intent of this subchapter is to provide for an authorization process for special purpose financial captive insurance companies that is both thorough and swift, and for the ongoing regulation of such companies that recognizes and accommodates the special purpose nature of such entities.
76 Del. Laws, c. 161, §  15;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter III. Special Purpose Financial Captive Insurance Companies › § 6953. Application of subchapter.

§ 6953. Application of subchapter.
(a) Except as otherwise provided, subchapters I, II, and IV of this chapter apply under this subchapter to special purpose financial captive insurance companies.
(b) The Commissioner, by rule or order, at the Commissioner's discretion and on a case-by-case basis, may exempt a special purpose financial captive insurance company, or 1 or more protected cells of a special purpose financial captive insurance company that is also a sponsored captive insurance company, from 1 or more of the provisions of this chapter.
(c) This subchapter is not intended to limit the transactions in which a captive insurance company other than a special purpose financial captive insurance company may engage, and this subchapter does not apply to any such other captive insurance company.
76 Del. Laws, c. 161, §  15;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter III. Special Purpose Financial Captive Insurance Companies › § 6954. Application requirements.

§ 6954. Application requirements.
In addition to the items required under § 6903 of this title and, as applicable, under § 6933 of this title, a special purpose financial captive insurance company's plan of operation must include the following:
(1) A description of the contemplated special purpose financing transaction and the SPFC contract;
(2) Copies, or, at the discretion of the Commissioner, a written summary, of all material agreements, instruments or documents, including, without limitation, opinions of Delaware legal counsel regarding compliance of the SPFC contract and the special purpose financing transaction with the requirements of this chapter, that are to be entered into or required to effectuate the SPFC contract and the special purpose financing transaction, which must include:
a. The name of the counterparty;
b. The nature of the risks being assumed;
c. The proposed use of protected cells, if any; and
d. The amounts, purpose, nature and interrelationships of the various transactions required to effectuate the SPFC contract and the special purpose financing transaction;
(3) The proposed investment policy of the special purpose financial captive insurance company and a description of its proposed investment strategy;
(4) A description of the underwriting, reporting, and claims payment methods by which losses covered by the SPFC contract are to be reported, accounted for, and settled; and
(5) Pro forma balance sheets, income statements, and other financial projections demonstrating the performance of the special purpose financial captive insurance company pursuant to the SPFC contract under such stress case scenarios as may be required by the Commissioner.
76 Del. Laws, c. 161, §  15;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter III. Special Purpose Financial Captive Insurance Companies › § 6956. Securities of special purpose financial captive insurance companies.

§ 6956. Securities of special purpose financial captive insurance companies.
(a) A special purpose financial captive insurance company may:
(1) Subject to the approval of the Commissioner, account for the proceeds of surplus notes issued by the special purpose financial captive insurance company as surplus and not as debt for purposes of statutory accounting; and
(2) Submit to the Commissioner periodic written requests for the advance approval by the Commissioner of the special purpose financial captive insurance company's making payments of interest on and repayments of principal of surplus notes.
(b) The Commissioner may approve, in advance, ongoing interest payments or principal repayments, or both, by the special purpose financial captive insurance company, provided that the interest payments or principal repayments, or both, are made in accordance with the plan of operation and formulas contained in the plan of operation.
(c) Notwithstanding the provisions of subsection (b) of this section, payment of interest or repayment of principal may not be made without the approval of the Commissioner if the operation or financial condition of the special purpose financial captive insurance company deviates from the formula approved by the Commissioner pursuant to subsection (b) of this section or if the payment of interest or repayment of principal threatens the solvency or liquidity of the special purpose financial captive insurance company.
(d) A security issued by a special purpose financial captive insurance company is not subject to regulation as an insurance contract. An investor in these securities or a holder of these securities is not considered to be transacting the business of insurance in this State solely by reason of having an interest in these securities. The underwriter's placement or selling agents and their partners, commissioners, officers, members, managers, employees, agents, representatives, and advisors involved in a special purpose financing transaction by a special purpose financial captive insurance company are not considered to be insurance producers or to be conducting business as an insurance company or as an insurance agency, brokerage, intermediary, advisory, or consulting business solely by virtue of their underwriting activities in connection with the special purpose financing transaction.
76 Del. Laws, c. 161, §  15;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter III. Special Purpose Financial Captive Insurance Companies › § 6958. Dividends and distributions.

§ 6958. Dividends and distributions.
(a) A special purpose financial captive insurance company may declare and pay dividends or other distributions to equity holders if the dividends or other distributions do not violate the provisions of this chapter, or jeopardize the fulfillment of the obligations of the special purpose financial captive insurance company pursuant to the special purpose financing transaction or the SPFC contract, or threaten the solvency or liquidity of the special purpose financial captive insurance company.
(b) A special purpose financial captive insurance company may not declare or pay any dividend or other distribution to equity holders if the dividend or distribution violates the terms of the special purpose financing transaction, and may not declare or pay any dividend or other distribution to equity holders which decreases the capital and surplus of the special purpose financial captive insurance company below the minimum amount required under § 6905 of this title.
(c) The Commissioner may approve, in advance, a special purpose financial captive insurance company's declaring and paying, on an ongoing basis, dividends or other distributions, or both, to equity holders, provided that each dividend or other distribution is made in accordance with the plan of operation and formulas contained in the plan.
76 Del. Laws, c. 161, §  15;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter III. Special Purpose Financial Captive Insurance Companies › § 6959. Delinquency.

§ 6959. Delinquency.
(a) Sections 6918 and 6938 of this title apply to any special purpose financial captive insurance company except as otherwise provided in this section.
(b) Any delinquency proceeding pursuant to Chapter 59 of this title, or any temporary restraining order or injunction issued pursuant thereto with respect to a counterparty, may not prohibit the transaction of business by a special purpose financial captive insurance company, including its performance of its obligations under a special purpose financing transaction, or any action or proceeding against a special purpose financial captive insurance company or its assets.
(c) The commencement of a summary proceeding with respect to a special purpose financial captive insurance company, and any order issued by the court in such a summary proceeding, may not prohibit payments by the special purpose financial captive insurance company or any action required to make the payment, provided that the payments:
(1) Are made pursuant to a special purpose financing transaction or an SPFC contract:
and
(2) Are consistent with the special purpose financial captive insurance company's plan of operation, its certificate of authority, and any order issued in connection therewith, as they may be amended from time to time.
(d) Notwithstanding any other provisions of this title or other laws of this State:
(1) A receiver of a counterparty may not take action seeking to void, and has no authority to void, a nonfraudulent transfer by a counterparty to a special purpose financial captive insurance company of money or other property made pursuant to an SPFC contract; and
(2) A receiver of a special purpose financial captive insurance company may not take action seeking to void, and has no authority to void, a nonfraudulent transfer by the special purpose financial captive insurance company of money or other property made to a counterparty pursuant to an SPFC contract or made pursuant to a special purpose financing transaction.
(e) Notwithstanding any other provision of this title or other laws of this State, the assets of a special purpose financial captive insurance company, including assets held in trust for the benefit of the counterparty, may not be consolidated with or included in the estate of a counterparty in any bankruptcy, insolvency, delinquency, or similar proceeding against the counterparty.
76 Del. Laws, c. 161, §  15;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter III. Special Purpose Financial Captive Insurance Companies › § 6960. Discount on reserves; report on reserves.

§ 6960. Discount on reserves; report on reserves.
(a) A special purpose financial captive insurance company shall file annually with the Commissioner an actuarial opinion on reserves provided by an approved independent actuary.
(b) A special purpose financial captive insurance company may discount its reserves in accordance with the actuarial opinion filed under this section, subject to review by the Commissioner.
76 Del. Laws, c. 161, §  15;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter III. Special Purpose Financial Captive Insurance Companies › § 6961. Certain actions by the Commissioner.

§ 6961. Certain actions by the Commissioner.
Other than under § 6959 of this title, the Commissioner shall notify a special purpose financial captive insurance company not less than 30 days before suspending, revoking, amending, or modifying its certificate of authority or any order issued in connection therewith. The notice must state the basis for the suspension, revocation, amendment, or modification. The special purpose financial captive insurance company must be afforded the opportunity for a hearing and all rights provided pursuant to the provisions of the Administrative Procedures Act, Chapter 101 of Title 29.
76 Del. Laws, c. 161, §  15;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter III. Special Purpose Financial Captive Insurance Companies › § 6962. Books and records.

§ 6962. Books and records.
Notwithstanding § 6907 of this title, a special purpose financial captive insurance company shall calculate reserves and otherwise report using statutory accounting principles, unless the Commissioner requires, approves, or accepts the use of generally accepted accounting principles or international accounting standards, in either case with any appropriate or necessary modifications or adaptations thereof required or approved or accepted by the Commissioner, and as supplemented by additional information required by the Commissioner.
76 Del. Laws, c. 161, §  15;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter IV. Branch Captive Insurance Companies › § 6971. Establishment of a branch captive.

§ 6971. Establishment of a branch captive.
A branch captive may be established in this State in accordance with the provisions of this chapter to write any line of business for which captive insurance companies are authorized under § 6903(a) of this title. In addition to the general provisions of this chapter, the provisions of this subchapter shall apply to branch captive insurance companies.
77 Del. Laws, c. 252, §  13;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter IV. Branch Captive Insurance Companies › § 6972. Definitions.

§ 6972. Definitions.
As used in this subchapter, unless the context require otherwise:
(1) “Alien captive insurance company” means any insurance company formed to write insurance business of a nature that the Commissioner determines is otherwise permissible under this chapter and is licensed pursuant to the laws of an alien jurisdiction which imposes statutory or regulatory standards in a form acceptable to the Commissioner on companies transacting the business of insurance in such jurisdiction.
(2) “Branch business” means any insurance business transacted by a branch captive insurance company in this State.
(3) “Branch captive insurance company” means any alien captive insurance company that has been issued a certificate of authority by the Commissioner to transact the business of insurance in this State through a business unit with a principal place of business in this State, and has not otherwise been issued a certificate of authority by the Commissioner to transact insurance under this chapter.
(4) “Branch operations” means any business operations of a branch captive insurance company in this State.
77 Del. Laws, c. 252, §  13;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter IV. Branch Captive Insurance Companies › § 6973. Security required.

§ 6973. Security required.
(a) No branch captive insurance company shall be issued a license unless it shall possess and thereafter maintain, as security for the payment of liabilities attributable to the branch operations:
(1) Minimum capital and surplus as set forth in § 6905 of this title; and
(2) Reserves on such insurance policies or such reinsurance contracts as may be issued or assumed by the branch captive insurance company through its branch operations, including reserves for losses, allocated loss adjustment expenses, incurred but not reported losses, and unearned premiums with regard to business written through the branch operations; provided, however, the Commissioner may permit a branch captive insurance company to credit against any such reserve requirement either of the following:
a. Assets belonging to the branch captive insurance company that are in trust for, or otherwise segregated and controlled by, a ceding company, that secure the reinsurance obligations of the branch captive insurance company to such ceding company; or
b. Assets belonging to a reinsurer if held in trust for, or otherwise under the control of the branch captive insurance company and that secure the obligations of such reinsurer to the branch captive insurance company.
(b) Subject to the prior approval of the Commissioner, the amounts required in paragraphs (a)(1) and (2) of this section may be held in the form of:
(1) A trust formed under a trust agreement and funded by assets acceptable to the Commissioner;
(2) An irrevocable letter of credit issued or confirmed by a bank approved by the Commissioner; or
(3) Any combination thereof.
(c) The Commissioner may, on a case by case basis, exempt a branch captive insurance company from any or all of the requirements of this section, provided the Commissioner finds satisfactory evidence of the branch captive insurer's financial stability.
77 Del. Laws, c. 252, §  13;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter IV. Branch Captive Insurance Companies › § 6974. Annual reports.

§ 6974. Annual reports.
(a) Notwithstanding § 6907 of this title, a branch captive insurance company shall file with the Commissioner a copy of all reports and statements required to be filed under the laws of the jurisdiction in which the foreign captive insurance company or alien captive insurance company is formed, verified by oath of 2 of its executive officers. Such reports and statements shall be filed with the Commissioner on the same day that such reports and statements are due in the domiciliary jurisdiction of the foreign captive insurance company or alien captive insurance company.
(b) If the Commissioner is satisfied that the annual report filed in accordance with subsection (a) of this section provides adequate information concerning the financial condition of the branch captive insurance company, the Commissioner may waive the requirement for completion of the annual report required under § 6907 of this title. If the Commissioner is not satisfied with the reports and statements filed pursuant to subsection (a) of this section, a report that meets the requirements of § 6907 of this title shall be filed with the Commissioner at such date as the Commissioner shall establish.
(c) If the foreign captive insurance company or alien captive insurance company is not required to file reports or statements in its domiciliary jurisdiction, the requirements of § 6907 of this title shall apply.
77 Del. Laws, c. 252, §  13;  80 Del. Laws, c. 46, §  13;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter IV. Branch Captive Insurance Companies › § 6975. Examination of branch captives.

§ 6975. Examination of branch captives.
(a) The examination of a branch captive insurance company pursuant to § 6908 of this title shall be of branch business and branch operations only, so long as the branch captive insurance company provides annually to the Commissioner a certificate of compliance, or its equivalent, issued by or filed with the licensing authority of the domiciliary jurisdiction of the foreign captive insurance company or alien captive insurance company, and demonstrates to the Commissioner's satisfaction that it is operating in sound financial condition in accordance with all applicable laws and regulations of such jurisdiction.
(b) Notwithstanding subsection (a) of this section, if the Commissioner elects to waive any of the requirements of § 6973 of this title pursuant to § 6973(c) of this title, the Commissioner shall examine so much of the financial condition and affairs of the foreign captive insurance company or alien captive insurance company as the Commissioner deems appropriate.
(c) As a condition of the issuance of a certificate of authority under this chapter, the foreign captive insurance company or alien captive insurance company shall grant authority to the Commissioner for examination of the affairs of such foreign captive insurance company or alien captive insurance company in the jurisdictions in which the foreign captive insurance company or alien captive insurance company is formed, operates or maintains books and records.
77 Del. Laws, c. 252, §  13;  80 Del. Laws, c. 46, §  14;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter IV. Branch Captive Insurance Companies › § 6976. Taxation of branch captives.

§ 6976. Taxation of branch captives.
In the case of a branch captive insurance company, the tax provided for in § 6914 of this title shall apply only to the branch business of such company.
77 Del. Laws, c. 252, §  13;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter V. Miscellaneous › § 6980. Federal Home Loan Bank membership.

§ 6980. Federal Home Loan Bank membership.
A captive insurance company may apply for and become a member of a Federal Home Loan Bank, as defined in 12 U.S.C. § 1422(1)(A). The Commissioner may issue such reasonable rules, regulations and orders as the Commissioner may deem necessary or desirable to effectuate the purposes of this section, including setting standards for captive insurance companies qualifying for, entering into, and reporting advance agreements with Federal Home Loan Banks.
80 Del. Laws, c. 46, §  15;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter V. Miscellaneous › § 6981. Repeals; effective date; applicability.

§ 6981. Repeals; effective date; applicability.
(a) Except as provided in subsection (b) of this section, this chapter shall apply to all captive insurance companies.
(b) Chapter 69 of this title as in effect prior to July 11, 2005, chapter is hereby repealed, except as set forth in the next sentence. Chapter 69 of this title as in effect on July 11, 2005, shall apply to any captive insurance company licensed under such chapter as of such date that has not submitted a written notice to the Commissioner under subsection (c) of this section.
(c) Any captive insurance company licensed in this State as of July 11, 2005, that otherwise would be subject to the application of Chapter 69 of this title as in effect on such date may elect to become subject to the application of this chapter instead by submitting to the Commissioner a written notice to that effect.
75 Del. Laws, c. 150, §  1;  76 Del. Laws, c. 161, §  14;  77 Del. Laws, c. 252, §  13;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 69. CAPTIVE INSURANCE COMPANIES › Subchapter V. Miscellaneous › § 6983. Short title.

§ 6983. Short title.
This chapter may be cited as the “Delaware Revised Captive Insurance Company Act.”
75 Del. Laws, c. 150, §  1;  76 Del. Laws, c. 161, §  14;  77 Del. Laws, c. 252, §  13;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 71. LONG-TERM CARE INSURANCE › § 7101. Statement of purpose.

§ 7101. Statement of purpose.
The purpose of this chapter is to promote the public interest; to promote the availability of long-term care insurance policies; to protect applicants for long-term care insurance, as defined in this chapter, from unfair or deceptive sales or enrollment practices; to establish standards for long-term care insurance; to facilitate public understanding and comparison of long-term care insurance policies; and to facilitate flexibility and innovation in the development of long-term care insurance coverage.
67 Del. Laws, c. 102, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 71. LONG-TERM CARE INSURANCE › § 7102. Scope.

§ 7102. Scope.
The requirements of this chapter shall apply to policies delivered or issued for delivery in this State on or after January 1, 1990. This chapter is not intended to supersede the obligations of entities subject to this chapter to comply with the substance of other applicable insurance laws insofar as such laws do not conflict with this chapter; provided, however, that laws and regulations designed and intended to apply to Medicare supplement insurance policies shall not be applied to long-term care insurance. A policy which is not advertised, marketed or offered as long-term care insurance or nursing home insurance need not meet the requirements of this chapter.
67 Del. Laws, c. 102, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 71. LONG-TERM CARE INSURANCE › § 7104. Extraterritorial jurisdiction; group long-term care insurance.

§ 7104. Extraterritorial jurisdiction; group long-term care insurance.
No group long-term care insurance coverage may be offered to a resident of this State under a group policy issued in another state to a group described in § 7103(4) of this title, unless this State or another state having statutory and regulatory long-term care insurance requirements substantially similar to those adopted in this State has made a determination that such requirements have been met.
67 Del. Laws, c. 102, §  1;  68 Del. Laws, c. 160, §  3;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 71. LONG-TERM CARE INSURANCE › § 7106. Nonforfeiture benefit requirement.

§ 7106. Nonforfeiture benefit requirement.
(a) No insurer may issue or deliver a long-term care insurance policy in this State unless the insurer offers to the applicant the option to purchase a policy that provides for nonforfeiture benefits.
(b) The Insurance Commissioner shall promulgate rules and regulations which specify the types of nonforfeiture benefits to be included in the policies and certificates, the standards for the benefits and the date nonforfeiture benefits must commence.
70 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 71. LONG-TERM CARE INSURANCE › § 7107. Administrative procedures.

§ 7107. Administrative procedures.
The Commissioner shall issue reasonable regulations to establish minimum standards for marketing practices, agent compensation, agent testing, penalties and reporting practices for long-term care insurance, and any other rules and regulations necessary for or as an aid to the administration or effectuation of this chapter. Regulations adopted pursuant to this chapter shall be in accordance with the provisions of Chapter 101 of Title 29.
67 Del. Laws, c. 102, §  1;  68 Del. Laws, c. 160, §  8;  70 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 71. LONG-TERM CARE INSURANCE › § 7109. Penalties.

§ 7109. Penalties.
In addition to any other penalties provided by the laws of this State, any insurer or agent found to have violated any requirement of this State relating to the regulation of long-term care insurance or the marketing of such insurance shall be subject to a fine of up to 3 times the amount of any commissions paid for each policy involved in the violation or up to $10,000, whichever is greater.
68 Del. Laws, c. 160, §  9;  70 Del. Laws, c. 351, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 72. SMALL EMPLOYER HEALTH INSURANCE › § 7201. Purpose.

§ 7201. Purpose.
The purpose and intent of this chapter are to promote the availability of health insurance coverage to small employers regardless of their health status or claims experience, to prevent abusive rating practices, to require disclosure of rating practices to purchasers, to establish rules regarding renewability of coverage, to establish limitations on the use of preexisting condition exclusions, to provide for development of “basic” and “standard” health benefit plans to be offered to all small employers, to provide for establishment of a reinsurance program, and to improve the overall fairness and efficiency of the small group health insurance market.
This chapter is not intended to provide a comprehensive solution to the problem of affordability of health care or health insurance.
68 Del. Laws, c. 175, §  1;  68 Del. Laws, c. 340, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 72. SMALL EMPLOYER HEALTH INSURANCE › § 7203. Applicability and scope.

§ 7203. Applicability and scope.
This chapter shall apply to any health benefit plan provided by a small employer which provides coverage to the employees of such small employer in this State.
68 Del. Laws, c. 175, §§  1, 3;  68 Del. Laws, c. 340, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 72. SMALL EMPLOYER HEALTH INSURANCE › § 7204. Establishment of classes of business.

§ 7204. Establishment of classes of business.
(a) A small employer carrier may establish more than 1 class of business only to reflect substantial differences in expected claims experience or administrative costs related to the following reasons:
(1) The small employer carrier uses more than 1 type of system for the marketing and sale of health benefit plans to small employers;
(2) The small employer carrier has acquired a class of business from another small employer carrier; or
(3) The small employer carrier provides coverage to 1 or more association groups that meet the requirements of § 3506 of this title.
(b) A small employer carrier may establish no more than 9 classes of business under subsection (a) of this section, except as provided for in subsection (d) of this section.
(c) The Commissioner may establish regulations to provide for periods of transition in order for a small employer carrier to come into compliance with subsections (a) and (b) of this section in the instance of acquisition of a block of business from another small employer carrier.
(d) The Commissioner may approve the establishment of more than 9 classes of business upon a finding that such action would enhance the efficiency and fairness of the small employer marketplace.
(e) A small employer carrier shall not transfer a small employer involuntarily into or out of a class of business. A small employer carrier shall not offer to transfer a small employer into or out of a class of business unless such offer is made to transfer all small employers in the class of business without regard to case characteristics, claim experience, health status or duration of coverage since issue.
68 Del. Laws, c. 340, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 72. SMALL EMPLOYER HEALTH INSURANCE › § 7206. Renewability of coverage.

§ 7206. Renewability of coverage.
(a) A health benefit plan subject to this chapter shall be renewable with respect to all eligible employees or dependents, at the option of the small employer, except in any of the following cases:
(1) Nonpayment of the required premiums;
(2) Fraud or misrepresentation of the small employer or, with respect to coverage of individual insureds, the insureds or their representatives;
(3) Noncompliance with the carrier's minimum participation requirements;
(4) Noncompliance with the carrier's employer contribution requirements;
(5) Repeated misuse of a provider network provision;
(6) The small employer carrier elects to nonrenew all of its health benefit plans delivered or issued for delivery to small employers in this State. In such a case the carrier shall:
a. Provide advance notice of its decision under this paragraph to the commissioner in each state in which it is licensed; and
b. Provide notice of the decision not to renew coverage to all affected small employers and to the commissioner in each state in which an affected insured individual is known to reside at least 180 days prior to the nonrenewal of any health benefit plans by the carrier. Notice to the commissioner under this subparagraph shall be provided at least 3 working days prior to the notice to the affected small employers;
(7) The Commissioner finds that the continuation of the coverage would:
a. Not be in the best interests of the policyholders or certificate holders;
b. Impair the carrier's ability to meet its contractual obligations.
In such instance the Commissioner shall assist affected small employers in finding replacement coverage;
(8) With respect to a carrier that offers a health benefit plan through a managed care plan, there is no longer any enrollee in connection with such plan that lives, resides or works in the service area of the carrier;
(9) An employer is no longer actively engaged in the business in which it was engaged on the effective date of the plan; or
(10) With respect to coverage that is made available only through 1 or more bona fide associations, the membership of an employer ceases.
(b) A small employer carrier that elects not to renew a health benefit plan under paragraph (a)(6) of this section shall be prohibited from writing new business in the small employer market in this State for a period of 5 years from the date of notice to the Commissioner.
(c) In the case of a small employer carrier doing business in 1 established geographic service area of the State, the rules set forth in this chapter shall apply only to the carrier's operations in that service area.
68 Del. Laws, c. 175, §  1;  68 Del. Laws, c. 340, §  1;  71 Del. Laws, c. 143, §  7;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 72. SMALL EMPLOYER HEALTH INSURANCE › § 7208. Notice of intent to operate as a risk-assuming carrier.

§ 7208. Notice of intent to operate as a risk-assuming carrier.
(a) (1) Each small employer carrier desiring to operate as a risk-assuming carrier shall make application to the Commissioner within 30 days of January 4, 1993 to operate as a risk-assuming carrier, pursuant to § 7209 of this title.
(2) The Commissioner may permit a carrier to modify its status at any time for good cause shown.
(3) The Commissioner shall establish an application process for small employer carriers seeking to change their status under this subsection.
(b) A reinsuring carrier that applies and is approved to operate as a risk-assuming carrier shall not be permitted to continue to reinsure any health benefit plan with the Program. Such a carrier shall pay a prorated assessment based upon business issued as a reinsuring carrier for any portion of the year that the business was reinsured.
68 Del. Laws, c. 340, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 72. SMALL EMPLOYER HEALTH INSURANCE › § 7209. Application to become a risk-assuming carrier.

§ 7209. Application to become a risk-assuming carrier.
(a) A small employer carrier may apply to become a risk-assuming carrier by filing an application with the Commissioner in a form and manner prescribed by the Commissioner.
(b) The Commissioner shall consider the following factors in evaluating an application filed under subsection (a) of this section:
(1) The carrier's financial condition;
(2) The carrier's history of rating and underwriting small employer groups;
(3) The carrier's commitment to market fairly to all small employers in the State or its established geographic service area, as applicable;
(4) The carrier's experience with managing the risk of small employer groups; and
(5) The effect of approval and disapproval on the small employer insurance market and the Delaware Small Employer Health Reinsurance Program pursuant to § 7210 of this title [repealed].
(c) The Commissioner may rescind the approval granted to a risk-assuming carrier under this section if the Commissioner finds that:
(1) The carrier's financial condition will no longer support the assumption of risk from issuing coverage to small employers in compliance with § 7207 of this title without the protection afforded by the Program;
(2) The carrier has failed to market fairly to all small employers in the State or its established geographic service area, as applicable; or
(3) The carrier has failed to provide coverage to eligible small employers as required in § 7207 of this title.
(d) A small employer carrier electing to be a risk-assuming carrier shall not be subject to the provisions of § 7210 of this title [repealed].
68 Del. Laws, c. 340, §  1;  69 Del. Laws, c. 403, §  6;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 72. SMALL EMPLOYER HEALTH INSURANCE › § 7211. Health benefit plan committee.

§ 7211. Health benefit plan committee.
(a) The Commissioner shall appoint a Health Benefit Plan Committee. The Committee shall be composed of representatives of carriers, small employers and employees, health-care providers and producers.
(b) The Committee shall recommend the form and level of coverages to be made available by small employer carriers pursuant to § 7207 of this title.
(c) The Committee shall recommend benefit levels, cost sharing levels, exclusions and limitations for the basic health benefit plan and the standard health benefit plan. The Committee shall also design a basic health benefit plan and a standard health benefit plan which contain benefit and cost sharing levels that are consistent with the basic method of operation and the benefit plans of health maintenance organizations, including any restrictions imposed by federal law.
(1) The plans recommended by the Committee may include cost containment features such as:
a. Utilization review of health-care services, including review of medical necessity of hospital and physician services;
b. Case management;
c. Selective contracting with hospitals, physicians and other health-care providers;
d. Reasonable benefit differentials applicable to providers that participate or do not participate in arrangements using restricted network provisions; and
e. Other managed care provisions.
(2) The Committee shall submit the health benefit plans described in paragraph (c)(1) of this section to the Commissioner and the Delaware Health Care Commission for approval within 180 days after the appointment of the Committee.
68 Del. Laws, c. 340, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 72. SMALL EMPLOYER HEALTH INSURANCE › § 7212. Periodic market evaluation.

§ 7212. Periodic market evaluation.
The board, in consultation with the Committee, shall study and report at least every 3 years to the Commissioner on the effectiveness of this chapter. The report shall analyze the effectiveness of the chapter in promoting rate stability, product availability and coverage affordability. The report may contain recommendations for actions to improve the overall effectiveness, efficiency and fairness of the small employer group health insurance marketplace. The report shall address whether carriers and producers are fairly and actively marketing or issuing health benefit plans to small employers in fulfillment of the purposes of the chapter. The report may contain recommendations for market conduct or other regulatory standards or action.
68 Del. Laws, c. 340, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 72. SMALL EMPLOYER HEALTH INSURANCE › § 7213. Waiver of certain state laws.

§ 7213. Waiver of certain state laws.
No law requiring the coverage of a health-care service or benefit, or requiring the reimbursement, utilization or inclusion of a specific category of licensed health-care practitioner, shall apply to a basic health benefit plan delivered or issued for delivery to small employers in this State pursuant to this chapter.
68 Del. Laws, c. 340, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 72. SMALL EMPLOYER HEALTH INSURANCE › § 7216. Regulations; exceptions.

§ 7216. Regulations; exceptions.
(a) The Commissioner may establish regulations to implement the provisions of this section and to assure that rating practices used by small employer carriers are consistent with the purposes of this chapter, including regulations that:
(1) Assure that differences in rates charged for health benefit plans by small employer carriers are reasonable and reflect objective differences in plan design (not including differences due to the nature of the groups assumed to select particular health benefit plans); and
(2) Prescribe the manner in which case characteristics may be used by small employer carriers.
(b) The Commissioner may suspend for a specified period the application of paragraph (a)(1) of this section as to the premium rates applicable to 1 or more small employers included within a class of business of a small employer carrier for 1 or more rating periods upon a filing by the small employer carrier and a finding by the Commissioner either that the suspension is reasonable in light of the financial condition of the small employer carrier or that the suspension would enhance the efficiency and fairness of the marketplace for small employer health insurance.
68 Del. Laws, c. 175, §  1;  68 Del. Laws, c. 340, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 72. SMALL EMPLOYER HEALTH INSURANCE › § 7217. Disclosure of rating practices; certification of compliance.

§ 7217. Disclosure of rating practices; certification of compliance.
(a) In connection with the offering for sale of any health benefit plan to a small employer, a small employer carrier shall make a reasonable disclosure, as part of its solicitation and sales materials, of all of the following:
(1) The extent to which premium rates for a specified small employer are established or adjusted based upon the actual or expected variation in claims costs or actual or expected variation in health status of the employees of the small employer and their dependents;
(2) The provisions of the health benefit plan concerning the small employer carrier's right to change premium rates and the factors, other than claim experience that affect changes in premium rates;
(3) The provisions relating to renewability of policies and contracts;
(4) The provisions relating to any preexisting condition provision; and
(5) The benefits available under all health benefit plans for which the employer is qualified.
(b) Each small employer carrier shall maintain at its principal place of business a complete and detailed description of its rating practices and renewal underwriting practices, including information and documentation that demonstrate that its rating methods and practices are based upon commonly accepted actuarial assumptions and are in accordance with sound actuarial principles.
(c) Each small employer carrier shall file with the Commissioner annually on or before March 15, an actuarial certification certifying that the carrier is in compliance with this chapter and that the rating methods of the small employer carrier are actuarially sound. Such certification shall be in a form and manner, and shall contain such information, as specified by the Commissioner. A copy of the certification shall be retained by the small employer carrier at its principal place of business.
(d) A small employer carrier shall make information and documentation described in subsection (b) of this section available to the Commissioner upon request. Except in cases of violations of this chapter, the information shall be considered proprietary and trade secret information and shall not be subject to disclosure by the Commissioner to persons outside of the Department except as agreed to by the small employer carrier or as ordered by a court of competent jurisdiction.
68 Del. Laws, c. 175, §  1;  68 Del. Laws, c. 340, §  1;  71 Del. Laws, c. 143, §  13;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 72. SMALL EMPLOYER HEALTH INSURANCE › § 7218. Factors for premium rates; premium rate variations; premium rate adjustments; “stop-loss” policies prohibited.

§ 7218. Factors for premium rates; premium rate variations; premium rate adjustments; “stop-loss” policies prohibited.
(a) The only factors, other than plan design and family composition, that may be considered by a small employer carrier in setting premium rates for small employer health insurance are age, health status, and size of the group. “Health status” as used in this section means medical condition, including physical and mental illnesses; claims experience; receipt of health care; evidence of insurability; medical history; and unhealthy lifestyle choices as defined in § 7202 of this title.
(b) The maximum premium rate variation between high and low small employer health insurance risk groups of 2 to 50 employees is a ratio of 5 for the high risk groups to 1 for the low risk groups. The ratio of premium rate variation between high and low risk small employee groups of 2 to 50 employees must decrease by a factor of .5 for high risk groups annually on July 1, until the premium rate variation ratio is 3 for the high risk groups to 1 for the low risk groups.
(c) The maximum premium rate variation between high and low small employer health insurance risk groups of a single employee, known as “groups of one,” is a ratio of 6 for the high risk groups to 1 for the low risk groups. The ratio of premium rate variation between high and low risk small employer groups of 1 must decrease by a factor of .5 for high risk groups of 1 annually on July 1, until the premium rate variation ratio is 4 for the high risk groups to 1 for the low risk groups. Nothing in this provision may be construed to create separate risk pools for groups of one and groups of 2 to 50.
(d) A group may not receive a premium rate adjustment for a change in the health status of the members of the group that exceeds 15%, whether higher or lower, from the prior year.
(e) A small employer health insurance carrier may make available, issue, or renew a “stop loss” policy to a small employer if that small employer employs more than 5 eligible employees, the majority of whom are employed within this State, on at least 50% of its working days during the preceding calendar quarter.
(f) Nothing herein shall apply to any company licensed under Chapter 69 of this title.
77 Del. Laws, c. 388, §§  1, 2;  78 Del. Laws, c. 25, §  1;  81 Del. Laws, c. 420, § 1;