Increased competition means more options for Delawareans, employers

For the second consecutive year, Delawareans will have access to increased options on the Health Insurance Marketplace, Insurance Commissioner Trinidad Navarro announced today, with 57 total plans offered by four insurers. In the 2024 plan year, consumers will have the opportunity to purchase plans from Celtic Insurance Company Ambetter Health of Delaware, a carrier new to the state’s marketplace, in addition to plans from Aetna Health, AmeriHealth Caritas, and Highmark Blue Cross Blue Shield of Delaware. As recently as the 2022 plan year, consumers had only one carrier and 12 plan options to choose from.

“Improving healthcare accessibility and affordability across our state is one of my top priorities, and I’m proud that our work has led both options and enrollments to an all-time high,” said Insurance Commissioner Trinidad Navarro. “In addition, our Office of Value-Based Health Care Delivery has confirmed carrier’s filings reflect compliance with our affordability standards, including increasing spending on primary care to lower overall cost of care. We look forward continuing to make progress in this work.”

Nearly 35,000 residents purchased plans on the Delaware Marketplace during last year’s open enrollment. After Advance Premium Tax Credits, premiums averaged $197. Nearly 6,000 residents were eligible for a premium of $10 a month or less. Enrollment numbers are expected to rise as Medicaid redeterminations continue following the end of the COVID-19 Public Health Emergency. A Special Enrollment Period for Marketplace plans is available for persons no longer eligible for Medicaid.

As always, Commissioner Navarro urges residents to be informed consumers and shop for the best plan for both their needs and their budget. 57 health plans and 12 dental plans are available to Delawareans for the 2024 plan year, and local navigators are available to assist in choosing the right plan. Open Enrollment takes place November 1 through January 15.

Be aware of non-compliant alternative health plans.

Individual Affordable Care Act (ACA) Marketplace Rates Announced

Following in-depth reviews by independent actuaries and the Office of Value-Based Health Care Delivery, rates for regulated 2024 health, dental, and small group insurance plans were also announced today.

Celtic Ins. Co. Ambetter Health of Delaware’s 24 new plans range in base cost, before premium tax credits or other subsidies, from $378 to $532. Aetna Health (as a PA Corp.) will increase rates by an average of 2%, with base rate for six plans ranging from $414 to $441. AmeriHealth Caritas will decrease rates an average of 4.52%. Base rates for their six Marketplace plans will cost $300 to $416. Highmark requested a rate increase, and an average increase of 3.2% was approved after an initial increase request of 4.9%. Their 18 Marketplace plans have base costs between $274 and $654.

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.

Other ACA and ACA-Compliant Rates
Off-market individual offerings include six plans from Aetna Health (as a PA Corp.), which will increase an average of 2% in cost for the future year. AmeriHealth Caritas will decrease its plan’s rates an average of 4.52%. Highmark’s two off-market plan costs will increase an average of 3.2% after an initial request of 4.9%.

Delta Dental will increase rates by an average of 4.2% for two offered marketplace plans, and one off-market plan. Dominion Dental will decrease ACA premiums by 0.1% on their 10 plans.

Off-market small group plan options will increase for the coming plan year, with rate finalization occurring in October. Rate submissions show 62 plan options offered by six carriers: Aetna Health, Aetna Health (as a PA Corp), Aetna Life, Highmark, Optimum Choice, and United Healthcare.

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, telehealth, lab services, and more.

Open enrollment for 2024 Health Insurance Marketplace plans begins November 1. Residents may qualify to enroll or change plans based on special circumstances throughout the year, such as income qualification, loss of health coverage, becoming a parent, or other qualifying factors.

Find out if you qualify for special enrollment.

Recent reports of misleading comments in response to consumer questions prompt bulletin re-issuance

The Delaware Department of Insurance has been made aware of recent misrepresentations related to the basis for premium changes in consumer-facing communications. In response, the department is reminding agents, producers, and insurers of their obligations to provide full explanations of rate changes to policyholders when asked. Additionally, the department is reissuing Universally Applicable Bulletin No. 1 relating to False or Misleading Representations Concerning How Insurance Rates Are Set in Delaware.

“In order to adjust rates in our state, insurers go through a robust regulatory process during which they have to justify their rates to our team before they are approved,” said Insurance Commissioner Trinidad Navarro. “Consumers deserve understandable and accurate explanations too. And insurers, producers, and agents are required to provide that information by law. We will continue to enforce these provisions that ensure Delawareans are treated honestly and fairly in both the rates they experience, and the explanations they are afforded.”

The Department of Insurance does not set insurance rates, instead, its role is to analyze proposed rate changes against specific, actuarily justified criteria to determine whether rates are fair for both consumers and the insurance industry alike.

18 Del. C. § 2304(2) makes it unlawful to “…[make] any assertion, representation or statement with respect to the business of insurance or with respect to any person in the conduct of the insurance business, which is untrue, deceptive or misleading.”

The bulletin reiterates that when an insured questions a premium change, the Department expects that a full explanation be provided by the company or agent. Industry professionals who offer responses to consumers that are deliberately misleading or claim the department has required the rate change shall be considered to be knowingly violating the statute.

View Universally Applicable Bulletin No. 1

More than 37,500 Delaware agents, policyholders, beneficiaries impacted

Following the receipt of additional data breach reports from insurers, including those related to the breach of the MOVEit file transfer services system used by third-party vendors, the Delaware Department of Insurance is updating this consumer alert and will be updating the online posting as information is received.

Residents who may be agents, policyholders, or beneficiaries of the following insurers should be aware that their personal data may have been compromised, and should watch for contact:

As shared during a June 26 consumer alert, the MOVEit data breach and other data security events trigger Delaware’s Insurance Data Security Act, which in addition to proactive data security measures and other requirements, mandates the following occur:

• Investigation of a cybersecurity event and correction of compromised information systems
• Detailed reporting to the Insurance Commissioner
• Notification to consumers within 60 days, except in cases where federal law or law enforcement agencies require or request modified timelines
  Consumers must be provided credit monitoring services at no cost for a period of at least one year in addition to receiving information regarding freezing one’s credit

Insurance Commissioner Trinidad Navarro encouraged consumers to protect their identities and reassured residents that the breach will be investigated thoroughly. “I take any breach of personal information very seriously, and encourage consumers affected to utilize the identity and credit protection services offered. Our Market Conduct staff, likely alongside investigators across the country, will work to investigate the situation and assess if appropriate safeguards were in place for the handling of data.”

The department worked with the General Assembly in 2019 to pass the Insurance Data Security Act and was one of the first states to implement the National Association of Insurance Commissioner’s model law. The law is an effort to fortify security measures and protect consumer data. It requires insurance companies and their vendors to follow certain data protection and breach protocols, including notification. The department may investigate violations of the Act and levy penalties accordingly.

Consumers should consider freezing their credit report due to the incident.

[Last Update: August 16, 2023 – Insurer and Producer added; Impact counts amended]

Insureds, agents, and beneficiaries should watch for notification

On June 16, PBI Research Services, a third-party vendor for Genworth Financial, disclosed a data breach that impacted the personal information of an estimated 2.5-2.7 million individuals, including about 8,000 Delaware residents. At this time, the company has indicated that the potentially compromised information may include agents, policyholders, and beneficiaries’ data including names, contact information, dates of birth, social security numbers, and policy numbers. Consumers are urged to be vigilant in protecting their data, as beneficiaries may not be aware of policies that contain their information, particularly in regard to life insurance benefits.

This event triggers Delaware’s Insurance Data Security Act, which in addition to proactive data security measures and other requirements, mandates the following now occur:

• Investigation of a cybersecurity event and correction of compromised information systems
• Detailed reporting to the Insurance Commissioner
• Notification to consumers within 60 days, except in cases where federal law or law enforcement agencies require or request modified timelines
• Consumers must be provided credit monitoring services at no cost for a period of at least one year in addition to receiving information regarding freezing one’s credit

Insurance Commissioner Trinidad Navarro encouraged consumers to protect their identities and reassured residents that the breach will be investigated thoroughly.

“I take any breach of personal information very seriously, and encourage consumers affected to utilize the identity and credit protection services offered. Our Market Conduct staff, likely alongside investigators across the country, will work to investigate the situation and assess if appropriate safeguards were in place for the handling of data.”

The department has received a relevant policyholder list, including consumers of long-term care, life insurance, and annuities lines, which investigators may use to check company compliance with the Act. Consumer service representatives may also use this information to help concerned agents, policyholders, and beneficiaries who contact the office.

This incident was a part of a significant cybersecurity attack involving the MOVEit file transfer system, with the breach likely occurring May 29-30 before a corrective action was implemented on June 2. The department has not at this time been notified of additional insurer or insured information being accessed as part of this breach.

The department worked with the General Assembly in 2019 to pass the Insurance Data Security Act and was one of the first states to implement the National Association of Insurance Commissioner’s model law. The law is an effort to fortify security measures and protect consumer data. It requires insurance companies and their vendors to follow certain data protection and breach protocols, including notification. The department may investigate violations of the Act and levy penalties accordingly.

Consumers can visit Genworth.com/MOVEit for updates and should consider freezing their credit report due to the incident.