Delaware § 3573 Limitations on preexisting condition limitations [For application of this section, see 79 Del. Laws, c. 99, § 19]

Delaware Statutes

§ 3573 — Limitations on preexisting condition limitations [For application of this section, see 79 Del. Laws, c. 99, § 19]

Delaware·Title 18·Part Insurance·Ch. 35 GROUP AND BLANKET HEALTH INSURANCE·Subch. Large Employer Health Insurance Standards

A health benefit plan that covers a large group in this State:

(1)Shall not deny, exclude or limit benefits for a covered individual because of a preexisting condition;

(2)May impose an affiliation period. An affiliation period shall run concurrently with any waiting period. A health maintenance organization may, in lieu of an affiliation period, use an alternative method to address adverse selection with the prior approval of the Commissioner;

(3)Shall waive an affiliation period for the period of time an individual was previously covered by creditable coverage if such creditable coverage was continuous to a date not more than 63 days prior to the effective date of the new coverage. For purposes of calculating continuous coverage, a waiting period shall not be considered a gap in co

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A health benefit plan that covers a large group in this State:

(1) Shall not deny, exclude or limit benefits for a covered individual because of a preexisting condition;

(2) May impose an affiliation period. An affiliation period shall run concurrently with any waiting period. A health maintenance organization may, in lieu of an affiliation period, use an alternative method to address adverse selection with the prior approval of the Commissioner;

(3) Shall waive an affiliation period for the period of time an individual was previously covered by creditable coverage if such creditable coverage was continuous to a date not more than 63 days prior to the effective date of the new coverage. For purposes of calculating continuous coverage, a waiting period shall not be considered a gap in coverage. This paragraph shall not preclude application of any waiting period applicable to all new enrollees under the plan. The method of crediting and certifying coverage shall be determined by the Commissioner by regulation; and

(4) May not exclude coverage for late enrollees for a preexisting condition.

A health benefit plan shall not establish rules for eligibility for any individual to enroll under the plan based on any health status-related factors in relation to the individual or a dependent of the individual.

Delaware § 3573 (Limitations on preexisting condition limitations [For application of this section, see 79 Del. Laws, c. 99, § 19]) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.