Delaware Health Insurance

Health insurance regulations in Delaware tend to be particularly loose, so it’s a good idea to keep yourself informed of what insurers are allowed (and not allowed) to do.  Below is a list of the most significant health-insurance regulations to keep in mind when shopping for a new policy in Delaware.

• The government of Delaware issues licenses to all health insurance companies eligible to do business within the state.  Any information included here applies only to licensed insurers, unless otherwise specified.
• By law, health insurance companies in Delaware must allow their customers to renew their health insurance at will, so long as those customers make their premium payments and abide by all policy rules.  As long as these conditions are met, your insurer is not allowed to cancel your health insurance for any reason, including illness or other health complications.
• Rates and premiums on health coverage are not significantly controlled by the state government of Delaware, so you should expect the cost of any policy you purchase to vary depending on such factors as your health, your age, and your geographic location.  Such details can also lead an insurer to refuse coverage altogether, if you are a new applicant.
• Delaware health insurers may, without restriction, exclude pre-existing conditions from being covered under any health plan they offer.  “Pre-existing condition,” in this case, means any health condition that existed before the policy’s coverage began.  Depending upon the particular company and policy in question this loosely-defined exclusion can be permanent, or it may expire after a certain waiting period.
• Small businesses in Delaware with between 2 and 50 employees are automatically eligible to purchase the same group health insurance (or at least a policy with similar benefits) that is currently being offered to other small businesses in the state.
• Delaware-based small businesses may be compelled to meet certain minimum participation requirements in order to keep their group health plan in effect.  Employers may also be required to contribute a portion of their employees’ premiums to keep the policy active.
• Health insurers in Delaware are permitted to set the rates for any small-business group policy at their discretion, which is usually influenced by the age, sex, and health status of the participants.  As with individual policies, however, it is illegal for any Delaware health insurance company to cancel a business’s group health plan due to illness among its members.
• If you are a Delaware resident who is Self-employed, you have the option of purchasing a small-business group health policy— even if you are your company’s only employee.  If you decide to take on an individual health policy instead, you can choose to deduct a sizable portion of your premiums from your overall tax liability.

Insurers in Delaware have great latitude in how they define and exclude pre-existing conditions, so it’s very important to make sure that you have some form of health coverage as early and continuously as possible.  When shopping for coverage, be sure to compare as many competitors’ rates as you can and carefully read over all policy stipulations before making your choice.

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