Following in-depth reviews by independent actuaries and the Office of Value-Based Health Care Delivery, rates for regulated 2023 health, dental, and small group insurance plans were announced today. While premiums are rising steeply across the country, the extension of consumer-friendly subsidies through the Inflation Reduction Act, coupled with Delaware’s strong 2022 enrollment and 2023 Health Insurance Marketplace expansion, will limit consumer impact locally.

“This year, Delaware consumers have more carriers and plans to choose from than ever before, so they can find an affordable plan that meets their needs. We remain optimistic that this increased competition will lead to lower rates and higher care quality over time,” said Insurance Commissioner Trinidad Navarro. “Delawareans are facing rising costs in nearly every area of life and making difficult sacrifices to afford necessities – but let me be clear, no matter the financial cost, we cannot afford to sacrifice our health. We will continue to work to ensure that coverage is affordable and accessible to all residents.”

Two new health insurers will be joining the Marketplace for 2023. Before tax credits and subsidies, base rates for 21-year-old non-tobacco users range from $315 to $505 across 9 Aetna CVS Health plan options, and from $283 to $402 with AmeriHealth Caritas across 4 plan options. Returning ACA issuer Highmark Blue Cross Blue Shield of Delaware will be increasing rates 5.5% on average, with base rates for 17 plan options ranging from $249 to $618 including a catastrophic plan option. In the last few years, Highmark’s average rates have decreased roughly 10% despite this needed increase.

Plans on the marketplace are spread among metal-level categories – bronze, silver, gold, platinum and catastrophic – and are based on how enrollees choose to split the costs of care with their insurance company.

As always, Commissioner Navarro urges residents to be informed consumers and shop for the best plan for both their needs and their budget. 30 plans are available to Delawareans for the 2023 plan year, and local navigators are available to assist in choosing the right plan. Open Enrollment takes place November 1 through January 15.

Factors Involved in Expansion, Rates

Nationally, insurers are requesting increases due to inflation, increasing costs of care, and rising drug prices. In Delaware, both state and federal legislation contributed to the long-awaited carrier expansion and final rates.

“It’s no coincidence that Delaware was able to expand the number of carrier options on the Health Insurance Marketplace in the same year that laws limiting hospital price growth to appropriate, inflation-conscious levels became enforceable,” said Commissioner Navarro. “The hospital price growth law, for the first time in our state’s history, gave insurers leverage to negotiate lower costs for consumers while still ensuring that hardworking healthcare providers receive their fair share. We’re grateful to have worked with legislators and the Primary Care Reform Collaborative to put cost containment guardrails in place to curtail rising consumer expenses, encourage carrier expansion, and ensure the effectiveness of every dollar spent.”

With little financial limitations around hospital prices, private insurance plans pay the price – on average 224% more than Medicare plans, according to RAND Corporation.

During the rate filing process, questions also remained about the expiration of American Rescue Plan Act subsidies, which the department lobbied Delaware’s congressional delegation to extend. These subsidies lowered consumer costs significantly and contributed to the state’s largest-ever ACA enrollment, a year-over-year increase of 26.8%. Had these benefits expired, healthy consumers who were influenced to acquire coverage through the enhanced discounts may have left the marketplace, shrinking the risk pool and unbalancing rates. On August 16, President Biden signed the Inflation Reduction Act into law, extending subsidies into 2025.

Aside from potential enrollment increases due to the carrier expansion, future participation growth may come from Medicaid unwinding and income eligibility reviews. National efforts are underway to ensure smooth, affordable transitions to Marketplace coverage for those eligible.

Other ACA and ACA-Compliant Rates

Delta Dental will reduce both ACA and non-marketplace rates by an average of 4%, and Dominion Dental will increase ACA premiums by 2.2%. Metropolitan Life Ins. Co.’s small group non-marketplace dental plan rates will remain at their current level.

Returning off-market small group plans from Highmark will increase an average 2.4%, Optimum Choice plans will rise by 2.7%, and United Healthcare small group rates will increase by 2.8%. Aetna Health’s small group plans will increase 7.6%, and Aetna Life rates will increase 5.1% after an initial increase request of 8.8% was reduced. Aetna Health’s 9 off-marketplace individual plan rates will remain at their current level.

About ACA Plans

All ACA-compliant health plans offer essential health benefits, including coverage of pre-existing conditions, prescriptions, emergency services and hospitalization, mental and behavioral health coverage, outpatient care and telehealth, lab services, and more.

Open enrollment for 2023 Health Insurance Marketplace plans begins November 1. Residents may qualify to enroll or change plans based on special circumstances, such as income qualification, loss of health coverage, becoming a parent, or other qualifying factors throughout the year. Find out if you qualify for special enrollment.

Commissioner Navarro announces Health Insurance Marketplace expansion

Be aware of non-compliant alternative health plans

Consumers to have most options in history of Delaware Marketplace

After years of work to increase competition on the Delaware Health Insurance Marketplace, Insurance Commissioner Trinidad Navarro announced today that three health carriers intend to offer plans for the 2023 plan year – the most in the state’s history. AmeriHealth Caritas and Aetna CVS Health will join Highmark Blue Cross Blue Shield Delaware in offering coverage.

“Delaware’s Health Insurance Marketplace is more stable than ever before, with rates steadying and enrollment at an all-time high. The hard work we have put into this program is paying off, with multiple new carriers planning to offer 2023 coverage,” said Insurance Commissioner Trinidad Navarro. “I look forward to the benefits that increased competition will bring to our residents, and to continuing to improve healthcare accessibility and affordability across the state.”

From rising rates to insurer departure, the implementation of the Affordable Care Act in Delaware hasn’t always been smooth sailing. But with the state’s successful creation of a 1332 reinsurance program and federal threats of ending the critical program subsiding, rates have decreased more than 15% and remained stable, while enrollment has grown significantly.

“Today’s announcement is a testament to both the needs of Delawareans who have increasingly signed up for coverage, and to the strong regulatory environment we have built, which has helped insurers go from taking losses to being able to cover their expenses and consumers’ coverage needs.”

The announcement comes as carriers submit initial rate filings proposals pursuant to federal deadlines. These will undergo in-depth reviews by independent actuaries before the Insurance Commissioner approves and announces them later this year.

Successes in serving residents continue

The Delaware Department of Insurance (DOI) today published performance and productivity data for 2021. While the pandemic necessitated continued operational adjustments, staff continued to focus efforts on consumer services and saw great success. The department also released an infographic of key statistics.

“Year after year, our DOI team delivers for Delaware. In the face of many changes and challenges due to COVID-19, we continued to prioritize consumer services, and never wavered from that commitment,” said Insurance Commissioner Trinidad Navarro. “This year in review provides just a glimpse into the incredibly vast and diverse array of work our team takes on, and I look forward to continuing to make a difference every day in 2022.”

Despite minimal in-person events, services directed to individual consumers and local businesses continued to thrive in 2021. The Delaware Medicare Assistance Bureau (DMAB) held more than 5,500 free one-on-one counseling sessions with residents, ultimately saving beneficiaries a combined $521,000 – an increase of more than $230,000 compared to 2020 savings. The Consumer Services Division managed over 3,000 complaints and inquiries, recovering nearly $700,000 for consumers. In the Legal Division, 274 settled arbitration cases resulted in awards totaling more than $640,000. These services, combined with $12.3 million in ACA plan refunds and $7.4 million in workplace safety savings, amount to over $21.5 million for Delaware’s insurance consumers in 2021.

A critical focus of the department during COVID-19 continues to be ensuring health insurer compliance with state and federal rules, coverage requirements, and initiatives to reduce burdens on hospitals and those seeking care. The Market Conduct team continued investigations into insurer’s Mental Health Parity compliance, resulting in $635,000 in fines. Throughout the ACA Special Enrollment Period, more than 21,000 residents took advantage of increased subsidies and savings from the American Rescue Plan, saving an average of 53% on their monthly premiums – a savings of $1.2 million in total. To protect consumers and create a nationwide network of strong regulation, Commissioner Navarro successfully worked to create the National Improper Marketing of Health Plans Working Group within the National Association of Insurance Commissioners.

Nationally, Commissioner Navarro and the department remain engaged in numerous industry organizations. The Commissioner was recently named Vice-Chair of the National Association of Insurance Commissioners’ Market Regulation and Consumer Affairs (D) Committee, a prestigious honor, in addition to being elected to the Executive Committee of the Northeast Zone and continuing to serve as Chair of the National Anti-Fraud Task Force. Delaware continues to participate in the Special Committee on Race and Insurance, the Healthcare Fraud Prevention Partnership, the National Insurance Crime Bureau Medical Task Force, the Delaware Valley Association of International Special Investigative Units, and other committees and groups.

In 2021, the General Assembly utilized virtual procedures for session. DOI pursued 14 pieces of legislation with our partners in Legislative Hall and engaged with more than 30 insurance-related bills, including legislation to regulate the multi-billion-dollar Pharmacy Benefit Manager industry, protecting consumers of auto and homeowner’s insurance, and making progress on issues like health care access and pharmaceutical costs. The DOI also continued to work on other legislative mandates, such as the Office of Value-Based Health Care Delivery.

In Market Conduct, 16 completed insurer examinations resulted in $1.2 million in fines, and several examinations are in progress. More than 50,000 licenses were issued, and licenses total more than 200,000. Across all lines of insurance, more than 30,000 rates and forms were processed and approved.

The Bureau of Examination, Rehabilitation and Guaranty oversees the financials of 136 domestic companies that manage $680.6 billion, and more than 2,000 other companies operating in the state. They completed 62 financial examinations, and have 49 exams in progress, in addition to completing nearly 3,500 other projects including Uniform Certificate of Authority Application amendments and Security Exchange Requests.

The Fraud Bureau worked to investigate many tips and reports, and 5 criminal cases of insurance fraud were indicted in addition to the collection of nearly $9,500 in civil penalties.

Going into 2022, businesses will see the fifth consecutive decrease in Workers’ Compensation premiums, an average reduction of more than 20%. The Workplace Safety team engaged more than 1,200 companies in earning additional savings in 2021.

The Captive Division, named a finalist for International Captive Domicile of the Year, received 70 new applications and has 759 licenses in effect.

View the 2021 Infographic

NEW CASTLE (Feb. 3, 2022) – With strong public demand for coverage during the COVID-19 pandemic, enhanced federal subsidies, and Delaware’s reinsurance program keeping the cost of monthly premiums relatively steady, enrollment on Delaware’s Health Insurance Marketplace for 2022 set an all-time high, increasing 26.8% over the open enrollment total for 2021.

During Delaware’s ninth open enrollment period, which began on Nov. 1, 2021, and ended Jan. 15, 2022, a total of 32,113 Delawareans enrolled for health insurance on HealthCare.gov. During the previous year, sign-ups during the open enrollment period totaled 25,320.

For those who enrolled by Dec. 15, 2021, and paid their first premium, coverage began Jan. 1, 2022. For those who enrolled by Jan. 15, 2022, and paid their first premium, coverage began Feb. 1, 2022.

“We are pleased that an increasing number of Delawareans decided to buy coverage through Delaware’s Health Insurance Marketplace,” Governor John Carney said. “Being able to provide access to high-quality, affordable health care is one of the cornerstones of the Affordable Care Act. We are grateful to the Biden administration and the Congressional Delegation for providing enhanced federal subsidies on the marketplace plans to help improve access to health insurance for Delawareans.”

The Biden administration used American Rescue Plan Act funds to increase tax credits and expand subsidies further into the middle class. For instance, a family of four (both parents in their 40s) making $50,000 were eligible for a tax credit of roughly $16,500, compared with $14,300 previously. The vast majority of enrollees on Delaware’s marketplace were eligible for financial assistance, which helps to reduce the cost of monthly premiums and/or deductibles, and also lowers out-of-pocket health care costs.

“As we begin the recovery from COVID-19, providing this crucial access to high-quality, affordable health care is another way we will improve the overall health and well-being of Delawareans,” said Department of Health and Social Services (DHSS) Secretary Molly Magarik. “We urge everyone to use their coverage to get caught up on necessary screenings, vaccines and annual check-ups, and to work with health care providers to manage chronic health conditions, address emerging health care needs, and to improve their overall physical and behavioral health.”

Delawareans were able to choose from 13 health plans on the health insurance marketplace through Highmark Blue Cross Blue Shield Delaware. Two dental insurers – Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. – offer stand-alone dental plans on the marketplace. Monthly premiums for the 2022 health plans were about 3% higher on average than the 2021 plans due in part to increases in prescription costs and an anticipation of elective procedures resuming after being postponed due to the pandemic. This year’s single-digit increase in premiums follows decreases the previous two enrollment years, totaling more than 19%. Federal subsidies cut consumer costs across the country by an average of 40%, negating the small increase in base rates.

“Delaware’s Health Insurance Marketplace has seen great success in reducing our uninsured population – but the fact is that the pandemic increased it due to loss of employer-provided coverage. With the federal subsidies expanding, the 2021 Special Enrollment Period, and an extended enrollment period for 2022 plans, we were able to reach many of those in need of comprehensive coverage at an affordable price,” said Insurance Commissioner Trinidad Navarro. “It is my hope that Congress will not let the enhanced assistance expire at the end of the year so we can continue to serve those economically disadvantaged and middle-income families who have been hit hardest by the financial impacts of the pandemic.”

In June 2019, Governor Carney signed enabling legislation to create a reinsurance program in Delaware, and in August 2019, the Centers for Medicare and Medicaid Services (CMS) authorized the program. The program has lowered health insurance premiums for plans sold in the individual insurance market by partially reimbursing insurers for high-cost health care claims through a fund that uses a mix of federal funding and assessments collected by the Delaware Department of Insurance from health insurance carriers. Because the insurers’ claims costs are lower, the insurers can reduce the cost of premiums or limit increases. Delaware’s reinsurance program, which began Jan. 1, 2020, is administered by the Delaware Health Care Commission.

In September 2021, the Biden administration awarded Delaware $10.8 million through CMS to improve access to affordable, comprehensive health insurance coverage through its section 1332 state-based reinsurance waiver.

With the end of open enrollment on the health insurance marketplace, Delawareans can enroll for coverage only if they experience a life event that qualifies them for a special enrollment period. Among the many qualifying life events are birth or adoption of a child, a permanent move, loss of other coverage through a job, and marriage or divorce. Visit HealthCare.gov/screener/ to see if you qualify.

In addition to the health insurance marketplace, some Delawareans might be eligible for coverage through Delaware’s expanded Medicaid program, which is open year-round. More than 10,000 Delawareans have received coverage under the Medicaid expansion. To be screened for eligibility or to apply for Medicaid benefits, go to Delaware ASSIST.

NEW CASTLE (Nov. 1, 2021) – As the COVID-19 pandemic continues, Delawareans seeking health insurance, especially those who have lost coverage, can shop for 2022 coverage through the Health Insurance Marketplace. Enhanced federal subsidies, which began earlier this year under the Biden administration, will continue for 2022. The subsidies have helped to reduce consumer costs by as much as 40%.

The marketplace’s ninth open enrollment period started today, Nov. 1, and ends Saturday, Jan 15, 2022, at www.HealthCare.gov, where consumers can renew existing coverage or sign up for a new plan. Coverage for enrollees who sign up by Dec. 15 and pay their first month’s premium will take effect Jan. 1, 2022.

Individuals who don’t act by Jan. 15, 2022, cannot get coverage for 2022 unless they qualify for a Special Enrollment Period based on circumstances such as a loss of qualifying health coverage, change of income, becoming a parent, or other qualifying factors.

Monthly premiums for 2022 plans in Delaware will be 3% higher on average than the 2021 plans, Insurance Commissioner Trinidad Navarro announced in August. Highmark Blue Cross Blue Shield Delaware is the sole health insurer offering plans on Delaware’s Health Insurance Marketplace. Enrollees will choose one of 13 Highmark plans or they will be re-enrolled automatically in a plan similar to their current one.

This year’s single-digit increase in premiums follows decreases the last two enrollment years, totaling more than 19%. Those base premium reductions and the overall stability of Delaware’s Health Insurance Marketplace reflect continued federal approval of Delaware’s reinsurance program. The program has lowered health insurance premiums for plans sold in the individual insurance market by partially reimbursing insurers for high-cost health care claims through a fund that uses a mix of federal funding and assessments collected by the Delaware Department of Insurance from health insurance carriers. Because the insurers’ claims costs are lower, the insurers can reduce the cost of premiums or limit increases.

In addition, the Biden administration has made increased access to health insurance and affordability a priority by using American Rescue Plan Act funds to increase tax credits and expand subsidies further into the middle class. For instance, a family of four (both parents in their 40s) making $50,000 are eligible for a credit of roughly $16,500, compared with $14,300 previously. A majority of Delaware marketplace enrollees will be eligible for financial assistance, which can help reduce the cost of monthly premiums and/or deductibles, and lower out-of-pocket health care costs.

Through last year’s Open Enrollment and a Special Enrollment Period held earlier this year for people who lost coverage because of the pandemic, about 30,000 Delawareans now have coverage through Delaware’s Health Insurance Marketplace.

Federal tax credits are available for those whose household income is between 138% and 400% of the Federal Poverty Level. For 2022 coverage, that’s between $17,775 and $51,520 for an individual, or between $36,570 and $106,000 for a family of four. For coverage in 2021, about 81% of enrollees in Delaware were eligible for tax credits, which help reduce the cost of the monthly premium.

“All Delaware families need access to affordable, quality health care,” said Governor John Carney. “Delaware’s reinsurance program has stabilized premiums on the marketplace and the Biden administration has enhanced federal subsidies to make coverage even more affordable, even reaching into the middle class. As we continue to battle COVID-19, having access to affordable coverage is especially critical. I particularly encourage small-business owners, independent contractors and individuals who don’t have access to health insurance through an employer to check out the plans available on Delaware’s marketplace.”

Plans on the marketplace are spread among metal-level categories – bronze, silver, gold, platinum and catastrophic – and are based on how enrollees choose to split the costs of care with their insurance company. Bronze plans have low monthly premiums but high costs when you need care; gold plans have high premiums but lower costs when you need care. In a silver plan, the insurer pays about 70% of medical costs and the consumer pays about 30%. Consumers who pick silver health care plans might also qualify for additional savings through discounts on deductibles, copayments, and coinsurance. In Delaware, about 25% of current enrollees qualify for cost-sharing reductions. For any marketplace plan in 2022, individual consumers can’t pay more than $8,700 in out-of-pocket medical costs and families can’t pay more than $17,400.

For 2022, Highmark will offer 13 plans for individuals – four gold plans, three silver, three bronze, two platinum and one catastrophic. Two dental insurers – Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. – will offer a collective 12 stand-alone dental plans on the marketplace, seven with a low actuarial level (71.6%) and five with a high actuarial level (84.2%).

All plans offer essential health benefits such as coverage of pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, pediatric services, birth control and breastfeeding coverage, and COVID-19 vaccines, including any necessary boosters. In addition, coverage cannot be terminated due to a change in health status, including diagnosis or treatment of COVID-19.

“Providing access to high-quality, affordable health care is one of the ways that we can improve the overall health and well-being of Delawareans,” said Department of Health and Social Services Secretary Molly Magarik. “We are grateful to President Biden and our Congressional Delegation for enhancing federal subsidies to help people pay their monthly premiums. I urge everyone to take another look at the affordability of the plans on Delaware’s Health Insurance Marketplace and look at how the coverage can fit into your family’s budget. Finally, with community transmission of COVID-19, we know how important having coverage is for Delawareans, especially those with chronic conditions or in other vulnerable circumstances.”

This year’s slight increase in premiums comes as the market has stabilized after a significant reduction over 19% over the past two years, said Insurance Commissioner Trinidad Navarro. “Now, more than ever, it is vital that every resident can afford the insurance they need for their families. With our work towards lower rates in recent years and the assistance of the American Rescue Plan, plans are more accessible than ever before. More than 20 percent of Delaware Marketplace participants were enrolled in a plan costing $10 or less a month in the past year.”

Assistance for Delaware enrollees

Consumers can go to HealthCare.gov or CuidadodeSalud.gov now to explore their options for 2022 coverage, and they can enroll anytime between Nov. 1 and Jan. 15, 2022.

Delawareans who need help enrolling in coverage will have access to free in-person assistance from federally funded and trained specialists at Westside Family Healthcare (statewide) and Quality Insights, Inc., (New Castle and Sussex counties) and by certified application counselors at Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown. Westside and Quality Insights each received federal funding for navigators to help people enroll for coverage.

State-licensed insurance agents and brokers are also available to help individuals re-enroll and to help employers update their coverage, at no extra charge.

For more information, go to www.ChooseHealthDE.com. You can enroll in marketplace coverage at HealthCare.gov or by calling 1 (800) 318-2596 (TTY: 1-855-889-4325).

According to the U.S. Department of Health and Human Services (HHS):

• Delaware’s total open enrollment for 2021 (25,320) increased about 5.6% over the previous year.
• About 81% of Delaware’s marketplace enrollees receive financial assistance to help pay their monthly premiums and/or deductibles and co-pays.
• The overall average monthly premium in Delaware is $675, with the average premium reduced to $211 per month after tax credit. For the 81% of
• Delawareans who receive financial assistance, the average premium after tax credit is $119 per month.
• Among the 25,320 people who signed up during last year’s open enrollment, about 80% were re-enrollees and 20% were new enrollees.
• Financial help is available for individuals with annual incomes up to $51,520; for a family of four the income limit is $106,000.
• About 74% of Delaware’s enrollees signed up during the final three weeks of open enrollment in 2020.

The 11-year-old Affordable Care Act (ACA), which created the Health Insurance Marketplace, allows states to waive certain ACA requirements in order to customize their health insurance systems while retaining the basic protections of the ACA. In August 2019, Governor Carney signed legislation codifying various ACA consumer protections into state law and ensuring that if the ACA is ever repealed or changed, its consumer protections will remain in effect in Delaware. This includes provisions such as guaranteed-issue coverage (regardless of medical history), coverage for essential health benefits, a ban on lifetime and annual benefit maximums, limits on out-of-pocket costs, and rules regarding the factors that insurers can use to set premiums.

Support from Congressional Delegation

Delaware’s U.S. senators and representative urged uninsured Delawareans to find out what’s available for them on the marketplace.

“No one should be without affordable, quality health insurance and starting Nov. 1, Delawareans are eligible to sign up for a plan that meets their needs and budget,” said U.S. Sen. Tom Carper. “Especially during a pandemic, I encourage everyone to visit HealthCare.Gov or seek free help from our many health insurance navigators and get covered without delay!”

“Affordable and comprehensive health insurance is critical, especially during a pandemic and nearing the height of flu season,” said U.S. Sen. Chris Coons. “Open enrollment is an opportunity for Delawareans to review and update existing health care plans or look for new coverage that best meets your needs. I’m encouraging everyone, whether you’ve got health coverage or not, to visit Delaware’s Health Insurance Marketplace to review coverage options and explore financial assistance that may be available before January 15.”

“In the midst of a pandemic, we’ve been starkly reminded of the importance of health insurance. That’s why I join with my colleagues and partners in telling Delawareans that November 1st marks the beginning of the open enrollment period for the Affordable Care Act,” said U.S. Rep. Lisa Blunt Rochester. “Experts and navigators will be on hand to help Delawareans select the plan that works best for them and their families and I encourage everyone to visit HealthCare.Gov to find out more and enroll.”

In addition to the Health Insurance Marketplace, some residents might be eligible for coverage through Delaware’s expanded Medicaid program, which is open year-round. More than 10,000 Delawareans receive coverage under the Medicaid expansion each year. To be screened for or to apply for Medicaid benefits, go to Delaware ASSIST. Note: As of Oct. 1, 2020, dental care is included in coverage for adult Medicaid enrollees in Delaware.

Both the Health Insurance Marketplace and the Medicaid expansion have helped to reduce Delaware’s uninsured rate, decreasing from 10% in 2008 to 6.6% in 2019, according to the Census Bureau. That decline includes Delawareans who could not get coverage before the Affordable Care Act because of pre-existing conditions.