Delaware Code
Subchapter I. General Provisions
§ 3334. Franchise health insurance law.

Health insurance on a franchise plan is hereby declared to be that form of health insurance issued to:

(1) Three or more employees of any corporation, copartnership, or individual employer or any governmental corporation, agency or department thereof; or
(2) Ten or more members, employees or employees of members of any trade or professional association or of a labor union or of any other association having had an active existence for at least 2 years where such association or union has a constitution or bylaws and is formed in good faith for purposes other than that of obtaining insurance;
where such persons with or without their dependents are issued the same form of an individual policy varying only as to amounts and kinds of coverage applied for by such persons under an arrangement whereby the premiums on such policies may be paid to the insurer periodically by the employer, with or without payroll deductions, or by the association or union for its members, or by some designated person acting on behalf of such employer or association or union. The term “employees” as used herein may be deemed to include the officers, managers and employees and retired employees of the employer and the individual proprietor or partners if the employer is an individual proprietor or partnership.

Structure Delaware Code

Delaware Code

Title 18 - Insurance Code

Chapter 33. HEALTH INSURANCE CONTRACTS

Subchapter I. General Provisions

§ 3301. Scope of chapter.

§ 3302. Short title.

§ 3303. Scope, format of policy [For application of this section, see 79 Del. Laws, c. 99, § 19].

§ 3304. Required provisions; captions; omissions; substitutions.

§ 3305. Entire contract; changes.

§ 3306. Time limit on certain defenses.

§ 3307. Grace period.

§ 3308. Reinstatement.

§ 3309. Notice of claim.

§ 3310. Claim.

§ 3311. Proofs of loss.

§ 3312. Time of payment of claims.

§ 3313. Payment of claims.

§ 3314. Physical examination; autopsy.

§ 3315. Legal actions.

§ 3316. Change of beneficiary.

§ 3317. Optional policy provisions.

§ 3318. Change of occupation.

§ 3319. Misstatement of age.

§ 3320. Overinsurance; all coverages.

§ 3321. Relation of earnings to insurance.

§ 3322. Unpaid premiums.

§ 3323. Conformity with state statutes.

§ 3324. Illegal occupation.

§ 3325. Intoxicants and narcotics.

§ 3326. Renewability.

§ 3327. Order of certain provisions.

§ 3328. Third-party ownership.

§ 3329. Requirements of other jurisdictions.

§ 3330. Policies issued for delivery in another state.

§ 3331. Conforming to statute.

§ 3332. Age limit.

§ 3333. Filing of rates.

§ 3334. Franchise health insurance law.

§ 3335. Newborn children.

§ 3336. Midwife services reimbursement.

§ 3337. Lead poisoning screening reimbursement [For application of this section, see 83 Del. Laws, c. 75, § 9].

§ 3338. Coverage of cancer monitoring test.

§ 3338A. Equal reimbursement for oral and intravenous anticancer medication.

§ 3338B. Coverage of drugs approved for treatment of certain cancers [For application of this section, see 81 Del. Laws, c. 180, §§ 3 and 4].

§ 3339. Refusal to contract.

§ 3340. Child abuse or neglect — Individual coverage.

§ 3341. Newborns and mothers health protection.

§ 3342. Obstetrical and gynecological coverage.

§ 3342A. Contraceptive coverage.

§ 3342B. Primary care coverage [For application of this section, see 81 Del. Laws, c. 392, § 12] [Effective until Jan. 1, 2027].

§ 3342B. Primary care coverage [For application of this section, see 81 Del. Laws, c. 392, § 12] [Effective Jan. 1, 2027].

§ 3343. Insurance coverage for serious mental illness [For application of this section, see 81 Del. Laws, c. 29, § 3; and 82 Del. Laws, c. 199, § 3].

§ 3344. Insurance coverage for diabetes.

§ 3344B. Cost sharing in prescription insulin drugs.

§ 3344C. Coverage for insulin pumps.

§ 3345. Annual pap smear coverage reimbursement.

§ 3346. Colorectal cancer screening.

§ 3347. Required coverage for reconstructive surgery following mastectomies.

§ 3348. Referrals.

§ 3349. Emergency care.

§ 3349A. Required coverage for volunteer ambulance company services.

§ 3350. Prescription medication.

§ 3350B. Copayment or coinsurance for prescription drugs limited [For application of this section, see 82 Del. Laws, c. 57, § 3].

§ 3351. Clinical trials.

§ 3351B. Experimental treatment coverage.

§ 3352. Newborn and infant hearing screening; coverage and reimbursement.

§ 3353. Use of social security numbers on insurance cards.

§ 3354. Supplemental coverage for children of insureds [For application of this section, see 79 Del. Laws, c. 99, § 19].

§ 3355. Phenylketonuria (PKU) and other inherited metabolic diseases.

§ 3356. Required coverage for scalp hair prosthesis.

§ 3357. Hearing aid coverage.

§ 3358. Dental services for children with a severe disability.

§ 3359. Health insurance; pharmacies; electronic reimbursement.

§ 3359B. Electronic medical (non-pharmaceutical) claims.

§ 3360. Screening of infants and toddlers for developmental delays.

§ 3362. Reimbursement for orthotic and prosthetic services.

§ 3363. Recommended immunizations.

§ 3364. Specialty tier prescription coverage.

§ 3365. School-based health centers.

§ 3366. Autism spectrum disorders coverage.

§ 3367. Payment for emergency medical services.

§ 3368. No lifetime or annual limits [For application of this section, see 79 Del. Laws, c. 99, § 19].

§ 3369. Notification and reasons for cancellation or nonrenewal [For application of this section, see 79 Del. Laws, c. 390, § 8].

§ 3370. Telehealth and telemedicine.

§ 3370A. Network disclosure and transparency.

§ 3370B. Coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome.

§ 3370C. Time of submitting claim for reimbursement.

§ 3370D. Coverage for epinephrine autoinjectors.

§ 3370E. Annual behavioral health well check [Effective Jan. 1, 2024].