Delaware-Rate Review Law

  • Delaware has prior-approval of rate increases for all individual market products.
  • Regulators have 30 days to approve or disapprove the rates; they are deemed approved if regulators do not respond with the 30-day period. Rates may not be disapproved unless they are inadequate, excessive or unfairly discriminatory. Del. Admin Code 18-1305 (Title 18), effective 1/11/2010.
  • Benefits are deemed reasonable in relation to premiums if medical loss ratios are met, based on coverage type.
  • As an alternative to prior approval review, an insurer may use rates upon filing if the insurer makes a lifetime and yearly medical loss ratio guarantee that rates meet or exceed the minimums, backed up by actuarial memorandum and “detailed experience information” and description of process used to develop loss ratio and supporting data.
  • Rate filings are not posted online.

Information is based on review of state statutes and regulations and in some case, interviews with state insurance departments.

IssuesHealth