Delaware Code
Subchapter III. Provisions Applicable to Group and Blanket Health Insurance
§ 3571M. Comprehensive health insurance coverage [For application of this section, see 79 Del. Laws, c. 99, § 19].

(a) Coverage for essential health benefits package. —
A health insurer that offers health insurance coverage in the small group market shall ensure that such coverage includes the essential health benefits package in conformity with § 1302 of the Patient Protection and Affordable Care Act [42 U.S.C. § 18022], as the law and its implementing regulations were in effect on January 1, 2018, and state law. The Commissioner shall issue a regulation setting forth what constitutes “essential health benefits” for purposes of this section.
(b) Cost-sharing under group health plans. —
A group health plan shall ensure that any annual cost-sharing imposed under the plan does not exceed the limitations provided for under § 1302(c)(1) and (2) of the Patient Protection and Affordable Care Act [42 U.S.C. § 18022(c)(1) and (2)], as the law and its implementing regulations were in effect on January 1, 2018, and state law.
(c) Child-only plans. —
If a health insurer offers health insurance coverage in any level of coverage specified under § 1302(d) of the Patient Protection and Affordable Care Act [42 U.S.C. § 18022(d)], as the law and its implementing regulations were in effect on January 1, 2018, or state law, the health insurer shall also offer such coverage in that level as a plan in which the only enrollees are individuals who, as of the beginning of the plan year, are under the age of 21.
(d) Dental only. —
This section shall not apply to a plan described in § 1311(d)(2)(B)(ii) of the Patient Protection and Affordable Care Act [42 U.S.C. § 18031(d)(2)(B)(ii)], as the law and its implementing regulations were in effect on January 1, 2018.

Structure Delaware Code

Delaware Code

Title 18 - Insurance Code

Chapter 35. GROUP AND BLANKET HEALTH INSURANCE

Subchapter III. Provisions Applicable to Group and Blanket Health Insurance

§ 3550. Newborn children.

§ 3551. Filing of rates.

§ 3552. Cancer screening tests.

§ 3553. Midwife services reimbursement.

§ 3554. Lead poison screening reimbursement [For application of this section, see 83 Del. Laws, c. 75, § 9].

§ 3555. Coverage of cancer monitoring tests.

§ 3555A. Equal reimbursement for oral and intravenous anticancer medication.

§ 3555B. Coverage of drugs approved for treatment of certain cancers [For application of this section, see 81 Del. Laws, c. 180, §§ 3 and 4].

§ 3556. Obstetrical and gynecological coverage.

§ 3556A. Primary care coverage [For application of this section, see 81 Del. Laws, c. 392, §  12] [Effective until Jan. 1, 2027].

§ 3556A. Primary care coverage [For application of this section, see 81 Del. Laws, c. 392, §  12] [Effective Jan. 1, 2027].

§ 3557. Child abuse or neglect — Group coverage.

§ 3558. Immunizations and preventive services.

§ 3559. Contraceptive coverage.

§ 3559A-3559C. Insurance coverage for diabetes; annual pap smear coverage reimbursement; colorectal cancer screening.

§ 3560. Insurance coverage for diabetes.

§ 3560A. Cost sharing in prescription insulin drugs.

§ 3560B. Coverage for insulin pumps.

§ 3561. Annual pap smear coverage reimbursement.

§ 3562. Colorectal cancer screening.

§ 3563. Required coverage for reconstructive surgery following mastectomy.

§ 3564. Referrals.

§ 3565. Emergency care.

§ 3565A. Required coverage for volunteer ambulance company services.

§ 3566. Prescription medication.

§ 3566A. Copayment or coinsurance for prescription drugs limited [For application of this section, see 82 Del. Laws, c. 57, § 3].

§ 3567. Clinical trials.

§ 3567B. Experimental treatment coverage.

§ 3568. Newborn and infant hearing screening; coverage and reimbursement.

§ 3569. Use of Social Security numbers on insurance cards.

§ 3570. Supplemental coverage for children of insureds [For application of this section, see 79 Del. Laws, c. 99, § 19].

§ 3570A. Autism spectrum disorders coverage.

§ 3571. Phenylketonuria (PKU) and other inherited metabolic diseases.

§ 3571A. Hearing aid coverage.

§ 3571B. Required coverage for scalp hair prosthesis.

§ 3571C. Dental services for children with a severe disability.

§ 3571D. Screening of infants and toddlers for developmental delays.

§ 3571E. Reimbursement for orthotic and prosthetic services.

§ 3571F. Mini-COBRA small employer group health policies [For application of this section, see 79 Del. Laws, c. 99, § 19].

§ 3571G. School-based health centers.

§ 3571H. Payment for emergency medical services.

§ 3571I. No lifetime or annual limits [For application of this section, see 79 Del. Laws, c. 9, § 19].

§ 3571J. Guaranteed availability of coverage [For application of this section, see 79 Del. Laws, c. 99, § 19].

§ 3571K. Prohibition on excessive waiting periods [For application of this section, see 79 Del. Laws, c. 99, § 19].

§ 3571L. Nondiscrimination in health care [For application of this section, see 79 Del. Laws, c. 99, § 19].

§ 3571M. Comprehensive health insurance coverage [For application of this section, see 79 Del. Laws, c. 99, § 19].

§ 3571N. Prohibiting discrimination against individual participants and beneficiaries based on health status [For application of this section, see 79 Del. Laws, c. 99, § 19].

§ 3571O. Insurance offered through the state health insurance exchange [For application of this section, see 79 Del. Laws, c. 99, § 19].

§ 3571P. Rating factors [For application of this section, see 79 Del. Laws, c. 99, § 19].

§ 3571Q. Notification and reasons for cancellation or nonrenewal [For application of this section, see 79 Del. Laws, c. 390, § 8].

§ 3571R. Telehealth and telemedicine.

§ 3571S. Network disclosure and transparency.

§ 3571T. Coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome.

§ 3571U. Mental Health Parity and Addiction Equity Act reporting requirements.

§ 3571V. Time of submitting claim for reimbursement.

§ 3571W. Electronic medical claims.

§ 3571X. Medication assisted treatment for drug and alcohol dependencies.

§ 3571Y. Coverage for epinephrine autoinjectors.

§ 3571Z. Annual behavioral health well check [Effective Jan. 1, 2024].