DE| Delaware Department of Insurance Bulletin No. 113 explains Delawares procedures for collecting a 2.75 percent assessment from health insurance carriers on assessable premiums to fund the Delaware Health Insurance Individual Market Stabilization and Reinsurance Program, details which entities and product lines are subject to or excluded from the assessment, outlines due dates, penalties, and allocation of funds to the Delaware Health Care Commission, and describes how the reinsurance mechanism is intended to lower premiums and improve market stability, particularly for unsubsidized individual market enrollees, under a Section 1332 waiver extended through 2029.
Key Points:
- The assessment applies broadly to health insurance carriers writing health coverage in Delaware (excluding specified products such as stand?alone dental, stand?alone vision, long?term care, disability income, accident?only, Medicare, Medicaid, and certain governmental plans), is calculated as 2.75 percent of amounts used to determine Delaware premium tax or exemption values, and is due annually by March 1, with penalties for late payment under 18 Del. C. § 329.
- Collected assessment funds are remitted by the Department of Insurance to the Delaware Health Care Commission, which uses them to operate the reinsurance program that reimburses carriers for a portion of high?cost individual market claims between annually set attachment point and cap levels, with the expectation that reduced carrier costs will translate into lower premiums and greater market stability.
- The Delaware Health Insurance Individual Market Stabilization and Reinsurance Program Assessment Form included with the bulletin requires carriers to report total direct written premiums, itemize excluded premiums (e.g., Medicare, FEHBP, stand?alone dental/vision, accident?only, disability, long?term care), calculate assessable premiums, and apply the 2.75 percent assessment factor to declare the assessment due, along with providing responsible party contact information.