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Subchapter I. General Provisions
§ 3301. Scope of chapter. - This chapter shall not apply to or affect: (1) Any...
§ 3302. Short title. - This subchapter may be cited as the “Uniform Health Policy...
§ 3303. Scope, format of policy [For application of this section, see 79 Del. Laws, c. 99, § 19]. - No policy of health insurance shall be delivered or issued...
§ 3304. Required provisions; captions; omissions; substitutions. - (a) Except as provided in subsection (b) of this section...
§ 3305. Entire contract; changes. - There shall be a provision as follows: “Entire Contract; Changes:
§ 3306. Time limit on certain defenses. - (a) There shall be a provision as follows: (1) After...
§ 3307. Grace period. - There shall be a provision as follows: “A grace period...
§ 3308. Reinstatement. - (a) There shall be a provision as follows: “Reinstatement: (b)...
§ 3309. Notice of claim. - (a) There shall be a provision as follows: “Notice of...
§ 3310. Claim. - There shall be a provision as follows: “Claim Forms:
§ 3311. Proofs of loss. - There shall be a provision as follows: “Proofs of Loss:
§ 3312. Time of payment of claims. - There shall be a provision as follows: “Time of Payment...
§ 3313. Payment of claims. - (a) There shall be a provision as follows: “Payment of...
§ 3314. Physical examination; autopsy. - There shall be a provision as follows: “Physical Examinations and...
§ 3315. Legal actions. - There shall be a provision as follows: “Legal Actions:
§ 3316. Change of beneficiary. - (a) There shall be a provision as follows: “Change of...
§ 3317. Optional policy provisions. - Except as provided in § 3304 of this title, no...
§ 3318. Change of occupation. - There may be a provision as follows: “Change of Occupation:
§ 3319. Misstatement of age. - There may be a provision as follows: “Misstatement of Age:
§ 3320. Overinsurance; all coverages. - (a) There may be a provision as follows: “Overinsurance: (1)...
§ 3321. Relation of earnings to insurance. - (a) There may be a provision as follows: “After the...
§ 3322. Unpaid premiums. - There may be a provision as follows: “Unpaid Premium:
§ 3323. Conformity with state statutes. - There may be a provision as follows: “Conformity with State...
§ 3324. Illegal occupation. - There may be a provision as follows: “Illegal Occupation:
§ 3325. Intoxicants and narcotics. - There may be a provision as follows: “Intoxicants and Narcotics:
§ 3326. Renewability. - Health insurance policies, other than accident insurance only policies, in...
§ 3327. Order of certain provisions. - The provisions which are the subject of §§ 3305-3326, inclusive,...
§ 3328. Third-party ownership. - The word “insured,” as used in this subchapter, shall not...
§ 3329. Requirements of other jurisdictions. - (a) Any policy of a foreign or alien insurer, when...
§ 3330. Policies issued for delivery in another state. - If any policy is issued by a domestic insurer for...
§ 3331. Conforming to statute. - (a) No policy provision which is not subject to this...
§ 3332. Age limit. - If any such policy contains a provision establishing, as an...
§ 3333. Filing of rates. - Each insurer issuing health insurance policies for delivery in this...
§ 3334. Franchise health insurance law. - Health insurance on a franchise plan is hereby declared to...
§ 3335. Newborn children. - (a) All individual and group health insurance policies providing coverage...
§ 3336. Midwife services reimbursement. - (a) This section shall apply to every individual policy, contract...
§ 3337. Lead poisoning screening reimbursement [For application of this section, see 83 Del. Laws, c. 75, § 9]. - (a) All individual health insurance policies which are delivered or...
§ 3338. Coverage of cancer monitoring test. - (a) Every individual health, sickness or accident insurance policy, contract...
§ 3338A. Equal reimbursement for oral and intravenous anticancer medication. - (a) Every individual policy or contract of health insurance, or...
§ 3338B. Coverage of drugs approved for treatment of certain cancers [For application of this section, see 81 Del. Laws, c. 180, §§ 3 and 4]. - No individual policy or contract of health insurance, or certificate...
§ 3339. Refusal to contract. - (a) An insurer shall not refuse to contract with or...
§ 3340. Child abuse or neglect — Individual coverage. - No individual policy or contract, or certificate issued thereunder, of...
§ 3341. Newborns and mothers health protection. - A carrier offering a health benefit plan shall comply with...
§ 3342. Obstetrical and gynecological coverage. - (a) This section applies to every individual policy or contract...
§ 3342A. Contraceptive coverage. - (a) For purposes of this section: (1) “Carrier” means any...
§ 3342B. Primary care coverage [For application of this section, see 81 Del. Laws, c. 392, § 12] [Effective until Jan. 1, 2027]. - (a) For purposes of this section: (1) a. “Carrier” means...
§ 3342B. Primary care coverage [For application of this section, see 81 Del. Laws, c. 392, § 12] [Effective Jan. 1, 2027]. - (a) For purposes of this section: (1) a. “Carrier” means...
§ 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]. - (a) Definitions. — For purposes of this section: (1) “ASAM...
§ 3344. Insurance coverage for diabetes. - (a) Every individual or group hospital service corporation contract, individual...
§ 3344B. Cost sharing in prescription insulin drugs. - (a) For purposes of this section, “prescription insulin drug” means...
§ 3344C. Coverage for insulin pumps. - (a) For purposes of this section, “insulin pump” means a...
§ 3345. Annual pap smear coverage reimbursement. - All individual health insurance policies which are delivered or issued...
§ 3346. Colorectal cancer screening. - (a) Every individual health, sickness or accident insurance policy contract...
§ 3347. Required coverage for reconstructive surgery following mastectomies. - (a) All individual health insurance policies, contracts or certificates that...
§ 3348. Referrals. - (a) This section applies to every policy or contract of...
§ 3349. Emergency care. - (a) This section applies to every policy or contract of...
§ 3349A. Required coverage for volunteer ambulance company services. - (a) For the purpose of this section: (1) “Ambulance run”...
§ 3350. Prescription medication. - (a) This section applies to every policy or contract of...
§ 3350B. Copayment or coinsurance for prescription drugs limited [For application of this section, see 82 Del. Laws, c. 57, § 3]. - (a) Definitions. — (1) “Carrier” — means any entity that...
§ 3351. Clinical trials. - (a) This section applies to every policy or contract of...
§ 3351B. Experimental treatment coverage. - (a) No individual policy or contract of health insurance, or...
§ 3352. Newborn and infant hearing screening; coverage and reimbursement. - (a) Any individual health insurance policy which is delivered, issued...
§ 3353. Use of social security numbers on insurance cards. - (a) As used in this section, “insurance card” means a...
§ 3354. Supplemental coverage for children of insureds [For application of this section, see 79 Del. Laws, c. 99, § 19]. - (a) Definitions. — As used in this section: (1) “Carrier”...
§ 3355. Phenylketonuria (PKU) and other inherited metabolic diseases. - (a) Definitions. — In this section the following words shall...
§ 3356. Required coverage for scalp hair prosthesis. - (a) Every individual health insurance policy, contract or certificate that...
§ 3357. Hearing aid coverage. - (a) For purposes of this section, the term “hearing aid”...
§ 3358. Dental services for children with a severe disability. - (a) Definitions. — As used in this section: (1) “Child...
§ 3359. Health insurance; pharmacies; electronic reimbursement. - (a) This section shall apply to: (1) Insurers and nonprofit...
§ 3359B. Electronic medical (non-pharmaceutical) claims. - (a) This section shall apply to all claims for healthcare...
§ 3360. Screening of infants and toddlers for developmental delays. - (a) Definitions. — As used in this section: (1) “Carrier”...
§ 3362. Reimbursement for orthotic and prosthetic services. - (a) Definitions. — For purposes of this section: (1) “Federal...
§ 3363. Recommended immunizations. - (a) This section applies to any health carrier providing coverage...
§ 3364. Specialty tier prescription coverage. - (a) Unless otherwise specifically provided, the definitions herein apply throughout...
§ 3365. School-based health centers. - (a) For purposes of this section, a school-based health center...
§ 3366. Autism spectrum disorders coverage. - (a) All individual health benefit plans as defined in §...
§ 3367. Payment for emergency medical services. - (a) As used in this section: (1) “Ambulance” shall have...
§ 3368. No lifetime or annual limits [For application of this section, see 79 Del. Laws, c. 99, § 19]. - (a) (1) Except as provided in subsection (b) of this...
§ 3369. Notification and reasons for cancellation or nonrenewal [For application of this section, see 79 Del. Laws, c. 390, § 8]. - A notice of cancellation or nonrenewal of health insurance coverage...
§ 3370. Telehealth and telemedicine. - (a) For purposes of this section: (1) “Distant site” means...
§ 3370A. Network disclosure and transparency. - (a) This section applies to every policy or contract of...
§ 3370B. Coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome. - (a) All individual health insurance policies, contracts, or certificates that...
§ 3370C. Time of submitting claim for reimbursement. - (a) For purposes of this section: (1) “Carrier” means any...
§ 3370D. Coverage for epinephrine autoinjectors. - (a) For purposes of this section, “epinephrine autoinjector” means a...
§ 3370E. Annual behavioral health well check [Effective Jan. 1, 2024]. - (a) As used in this section: (1) “Behavioral health well...
Subchapter II. Pre-Authorization Transparency
§ 3371. Definitions [For application of this section, see 82 Del. Laws, c. 44, § 3]. - In this section, the following words have the meanings indicated:...
§ 3372. . . Disclosure and review of pre-authorization requirements. - (a) A utilization review entity shall make any current pre-authorization...
§ 3373. . . Utilization review entity's obligations with respect to pre-authorizations in nonemergency circumstances. - (a) If a utilization review entity requires pre-authorization of a...
§ 3374. Utilization review entity's obligations with respect to pre-authorization concerning emergency health-care services. - A utilization review entity must follow all emergency procedures and...
§ 3375. Retrospective denial. - The utilization review entity may not revoke, limit, condition or...
§ 3376. Length of pre-authorization. - (a) A pre-authorization for pharmaceuticals shall be valid for 1...
§ 3377. Electronic standards for pharmaceutical pre-authorization. - No later than January 1, 2018, the insurer must accept...
§ 3378. Health-care services deemed preauthorized if a utilization review entity fails to comply with the requirements of this subchapter. - Any failure by a utilization review entity to comply with...
§ 3379. Waiver prohibited. - The provisions of this subchapter cannot be waived by contract...
§ 3380. Exemptions. - This subchapter shall not apply to policies or contracts designed...
§ 3381. Step therapy exception process [For application of this section, see 82 Del. Laws, c. 44, § 3]. - (a) When coverage of a prescription drug for the treatment...