DE| The Delaware Department of Insurance issued Bulletin No. 157 providing guidance to health insurers, health service corporations, and managed care organizations offering Qualified Health Plans (QHPs) on the ACA Marketplace regarding the re-filing of 2026 rates. This action is in response to a federal court injunction in City of Columbus et al. v. Kennedy et al., which temporarily blocks provisions of the federal Marketplace Integrity and Affordability Rule, affecting Actuarial Value (AV) standards. The bulletin outlines strict requirements for rate re-filings to restore compliance with pre-Rule AV standards and sets a submission deadline of September 22, 2025.
Key Points:
- Re-filing is allowed only for QHPs out of compliance with AV standards due to the injunction, with changes strictly limited to restoring compliance under previous AV thresholds.
- Permitted updates include AV calculation adjustments, benefit design/rate revisions for AV compliance, and corrections aligning with federal QHP certification—no broader changes are allowed.
- Carriers may opt to withdraw non-compliant plans if minimum metal level offerings in each county are maintained, and all revised filings must be submitted via SERFF by the specified deadline.
