2023 Delaware Code › Title 29 - State Government › Chapter 52. HEALTH CARE INSURANCE › § 5201. Definitions [Effective Jan. 1, 2024].

§ 5201. Definitions [Effective Jan. 1, 2024].
For purposes of this chapter:
(1) “Chronic care management” means the services in the Chronic Care Management Services Program, as administered by the Centers for Medicare and Medicaid Services, and includes Current Procedural Terminology (“CPT”) codes 99487, 99489, and 99490.
(2) An “eligible child dependent” is one who is:
a. The child of a regular officer, employee or eligible pensioner or spouse of a regular officer, employee or eligible pensioner, either by birth or adoption, who is under the age of 26 or is unmarried, regardless of age, and incapable of self support because of an intellectual, mental or physical disability which existed before age 21; or
b. An unmarried child under the age of 19 years or the age of 24 if a full time student who depends for support upon and resides with a regular officer, employee or eligible pensioner in a regular parent-child relationship and qualifies as a dependent of the regular officer, employee or eligible pensioner under Internal Revenue Code § 105 (26 U.S.C. § 105).
(3) An “eligible pensioner” is one who is receiving or is eligible to receive retirement benefits in accordance with the state employees' pension plan under Chapters 53 and 55 of this title, the State Police pension plan under subchapter II and subchapter III of Chapter 83 of Title 11, the pension plan for state judiciary under Chapter 56 of this title or one who is receiving retirement or disability benefits under the teachers' retirement and disability plan (Chapter 39 of Title 14). This paragraph shall not apply to members of boards or commissions. An “eligible pensioner” shall include those individuals who were employed by the county prothonotary offices immediately prior to October 1, 1987, and who chose to remain in their respective county pension plans and who would otherwise be eligible to receive retirement benefits in accordance with the state employees' pension plan under Chapters 53 and 55 of this title. An “eligible pensioner” shall include those employees who are receiving disability benefits pursuant to § 5253(c) of this title.
(4) “FDA” means the Food and Drug Administration.
(5) “Medicare” means the federal Medicare Program (U.S. Public Law 89-87, as amended) (42 U.S.C. § 1395 et seq.).
(6) “Plan” means the basic health-care insurance plan for state employees provided under this chapter.
(7) “Primary care” means health care provided by a physician or an individual licensed under Title 24 to provide health care, with whom the patient has initial contact and by whom the patient may be referred to a specialist and includes family practice, pediatrics, internal medicine, and geriatrics.
(8) A “regular officer or employee” means one who works the regularly scheduled full-time hours of the employing agency, or at least 30 or more hours per week or 130 hours per month (with allowable interruptions) in a position of a continuing nature on a regular schedule expected to last at least 1 year from the date of initial appointment. The appointing authority shall determine at the time of appointment the qualifications of an appointee regarding the continuing nature and appointment duration criteria of this paragraph. An employee appointed to temporary or seasonal positions and members of boards and commissions who were not receiving coverage under the State group health insurance contract on January 1, 1993, shall not be considered a “regular officer or employee” for the purposes of this chapter. A “regular officer or employee” called to active duty with Guard or Reserve for other than training purposes shall continue to receive state contributions toward health insurance coverage for a period of up to 2 years. A “regular officer or employee” shall also include an employee who is receiving disability benefits pursuant to § 5253(b) of this title.
(9) “Therapeutic equivalent” means a contraceptive drug, device, or product that is all of the following:
a. Approved as safe and effective.
b. Pharmaceutically equivalent to another contraceptive drug, device, or product in that it contains an identical amount of the same active drug ingredient in the same dosage form and route of administration and meets compendial or other applicable standards of strength, quality, purity, and identity.
c. Assigned, by the FDA the same therapeutic equivalence code as another contraceptive drug, device or product.
29 Del. C. 1953, §  5201;  57 Del. Laws, c. 319;  58 Del. Laws, c. 27;  62 Del. Laws, c. 158, §  1;  63 Del. Laws, c. 408, §  1;  64 Del. Laws, c. 297, §  1;  65 Del. Laws, c. 449, §§  1, 2;  67 Del. Laws, c. 47, §  61;  68 Del. Laws, c. 8, §  2;  69 Del. Laws, c. 64, §§  27, 65;  70 Del. Laws, c. 118, §  30;  71 Del. Laws, c. 132, §  35;  71 Del. Laws, c. 354, §  40;  72 Del. Laws, c. 94, §§  37, 41;  72 Del. Laws, c. 204, §  3;  74 Del. Laws, c. 421, §  3;  75 Del. Laws, c. 191, §  4;  75 Del. Laws, c. 227, §§  2, 3;  76 Del. Laws, c. 280, §  34;  78 Del. Laws, c. 18, §  1;  78 Del. Laws, c. 78, §  24;  78 Del. Laws, c. 179, §  275;  81 Del. Laws, c. 323, § 3;  81 Del. Laws, c. 392, §§   7, 10;  82 Del. Laws, c. 141, § 24;  83 Del. Laws, c. 237, § 8;  84 Del. Laws, c. 218, § 1;