Department of Insurance 2021 Data Shows over $21M in Consumer Savings

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


Medicare Assistance Bureau Shares Resources in Advance of Open Enrollment

Free one-on-one counseling and information available to residents; Bureau earns federal grant

The Delaware Medicare Assistance Bureau (DMAB), a division of the Delaware Department of Insurance, is encouraging residents to get ready for Medicare Open Enrollment. DMAB, which provides free, one-on-one Medicare counseling, offers a myriad of virtual appointment options for residents, as well as video tutorials and other guides that can assist in beneficiaries’ preparation. DMAB has provided more than 3,000 counseling sessions so far this year, saving beneficiaries more than $372,438 in premiums through application help.

DMAB will engage in thousands of counseling sessions during Medicare Open Enrollment, which takes place October 15 through December 7. During this time, beneficiaries can make changes to their health and drug coverage and review existing coverage against other options. DMAB will offer virtual appointments throughout this period, available via Webex, Duo, and Microsoft Teams, as well as by phone. Residents are encouraged to register for a MyMedicare.gov account prior to their counseling session so that DMAB can generate personalized plan comparisons.

“Our DMAB team works to increase residents’ understanding of the complex Medicare system and can even help save you money. I encourage the community to reach out to our team for Medicare assistance and information,” said Insurance Commissioner Trinidad Navarro.

A Virtual Medicare Seminar, which DMAB began to offer in 2020, is available on-demand online, and educates participants on topics including Medicare benefits, supplemental insurance policies, Medicare Advantage plans, prescription drug coverage and details on signing up. While specifically created for new or soon-to-be eligible beneficiaries, the informative series can be helpful for all Medicare participants.

“Many people have questions about Medicare and don’t know where to start, and COVID-19 has only increased the stress of choosing the right healthcare plans. We are here to help people in Delaware deal with the complex and often confusing health insurance system,” said DMAB Director Lakia Turner, “and, we’re more accessible than ever through our new virtual programs.”

As Medicare Open Enrollment approaches, the Department of Insurance reminds residents to scrutinize any contact during the open enrollment period to ensure it is from a known, credible source. The most frequent fraudulent contact occurs by phone, but residents should review all communications carefully.

“If you are receiving contact regarding Medicare that you did not initiate, or contact not from one of your healthcare providers, it could be fraudulent,” said Commissioner Navarro. “Protect your Medicare Number like you do your Social Security number or bank account information, and never give it out to unknown or unexpected callers.”

DMAB has been awarded a Medicare Improvement for Patients and Providers Act (MIPPA) 2021 Grant from the federal government, which will provide the bureau $71,943. The annual MIPPA grant has and will assist the bureau’s outreach, education, and one-on-one beneficiary assistance programs over the next year by assisting those beneficiaries who are likely to be eligible for the Low-Income Subsidy program (also called “Extra Help”) or Medicare Savings Programs.

The Delaware Medicare Assistance Bureau provides free one-on-one health insurance counseling for people eligible for Medicare. Residents can call DMAB at 1-(800) 336-9500 or (302) 674-7364 to set up a free, confidential session. Counselors can assist with Medicare, Medicaid, Medigap (Medicare supplement insurance), long term care insurance, billing issues, prescription savings, and much more.

 View DMAB’s 2021 Open Enrollment Flyer


Department of Insurance Announces 2020 Year-End Data

Insurance Commissioner Trinidad Navarro highlights successes, resilience

The Delaware Department of Insurance published today a series of statistics outlining performance and productivity during 2020. These metrics show successes notwithstanding the pandemic and operational changes such as working remotely. These data have been shared visually in the Department of Insurance 2020 Year in Review infographic.

“Despite facing challenges including COVID-19 and natural disasters, our team showed resolve and resilience in serving residents over the past year. From conducting our first ever Mental Health Parity examinations, to returning $21.5 million in health premiums to residents and small businesses, to responding to thousands of consumer inquiries and complaints, the challenges of 2020 did not slow us down,” said Commissioner Navarro. “I couldn’t be prouder to lead a department that makes a difference every day.”

As COVID-19 arrived in Delaware, the department acted swiftly to ensure cost did not hinder residents seeking testing or care and prepared for the eventual vaccine. Over several months, the department kept in frequent contact with both insurers and healthcare providers, supporting the Governor and General Assembly in efforts to increase access to telemedicine and working with the Governor’s office on a temporary moratorium on policy cancellations as the economy adjusted. With the pandemic came increased scam attempts, and as chair of the National Anti-Fraud Task Force, Commissioner Navarro helped identify national trends in these efforts, while also serving on the Coronavirus Anti-Fraud Coalition locally. Throughout the year, the department’s fraud unit took on 545 cases, and joined the Healthcare Fraud Prevention Partnership.

Voices for change sang loud throughout 2020, and the department joined them, participating in the NAIC Special Session on Race and Diversity in the Insurance Sector, and the Special Executive Committee on Race and Insurance. In this group, regulators from across the nation are examining diversity and inclusion within the industry, engaging with stakeholders on these issues and how they impact access to the industry and insurance products, and analyzing the sector to find and correct processes that would disadvantage people of color either directly or by proxy.

In August, Delaware experienced multiple catastrophic storms. Tornadoes ravaged communities and homes, and the department arrived in those neighborhoods shortly after to talk to residents and assure them that assistance would be provided. 7,125 total claims were filed as a result of the estimated $10 million in damages caused by these events.

Throughout the year, the department’s Consumer Services Division managed 3,630 complaints, recovering $941,104 for residents. When the department could not solve claim complaints through contact with insurers, the arbitration team helped residents earn fairer settlements without having to go to court. 302 settlements put a total of $702,000 in the pockets of policyholders.

The Delaware Medicare Assistance Bureau (DMAB), which provides Medicare beneficiaries counseling and assistance with plan selection, enrollment, and any Medicare issues, quickly implemented virtual meeting options and held 24 total outreach education events. DMAB provided 5,118 one-on-one counseling sessions to residents, an increase over 2019 despite the lack of in-person events and meetings. The work of this team in assisting with the selection of plans saved beneficiaries $286,956 in premium costs.

While DMAB worked with Medicare beneficiaries, the department worked to decrease the cost of care for all residents while increasing accessibility, including through long-term efforts like regulating Pharmacy Benefit Managers and standing up the Office of Value-Based Care. Partly as a result of successes in creating affordability, $21.5 million was returned to health insurance marketplace policyholders and participating small businesses, as the insurer’s Medical Loss Ratio calculation showed they were spending less on health claims. For the second straight year, the department approved a decrease to Health Insurance Marketplace rates, and ultimately saw a 5% increase in 2021 plan enrollment.

In 2020, the department completed the state’s first Mental Health Parity exams. Thousands of violations were uncovered, resulting in $597,000 in fines as insurers worked to correct issues and create a less discriminatory environment in the future. In total, the Market Conduct Division completed 12 exams and one multi-state exam. Insurers were fined a total of $1.1 million, the most in recent years.

Commissioner Navarro’s approval of a rate decrease in Workers’ Compensation saved Delaware employers $4 million throughout the year. This fall, he confirmed the fourth consecutive decrease in rates, which will be an 11.56% decrease in 2021 loss costs and an 8.8% decrease in the residual market. Increasing safety in the workplace decreases accidents and helps these costs stay low, and the Workplace Safety Program engaged 1,083 participating companies, earning a total safety credit of $7 million on their combined total premium of nearly $66 million.

After being named a finalist for the International Captive Insurance Domicile of the Year, the Captive Division licensed 70 new captives in 2020, including 67 conditional licenses. To date, no other state has released data to indicate they licensed more captives than Delaware last year. The work of the captive division reduced taxpayer burden by contributing $1 million to the City of Wilmington and $2.9 million to the State of Delaware General Fund in Fiscal Year 2020.

The department licensed a total of 220,977 professionals, 37,885 whose licenses were processed by the department over the last year. The rates and forms team reviewed a total of 1,251 rates, forms, and advertisements related to life and health insurance, and 27,258 property and casualty submissions. Through the department’s participation in the National Association of Insurance Commissioner’s Life Policy Locator, $1.45 million was found and returned to beneficiaries.

The department’s milestone year began with an in-depth, months-long process of accreditation with the National Association of Insurance Commissioners (NAIC) inside the Bureau of Examination, Rehabilitation and Guaranty (BERG) and the department as a whole. While undergoing the arduous accreditation process, BERG also conducted 55 financial examinations of companies in 2020, with 56 exams currently in progress.

“Each year, people ask me what my priority will be,” said Commissioner Navarro. “But my answer is always the same: the residents of Delaware. We will continue to prioritize consumers each and every day, and we are proud to show such strong results after a challenging year.”

Department of Insurance 2020 Year in Review infographic


Medicare Assistance Bureau Innovates to Serve Residents During COVID-19

More ways to receive Medicare counseling and information as Open Enrollment approaches, Bureau earns federal grants to support efforts

When COVID-19 required cancellation of the Department of Insurance Delaware Medicare Assistance Bureau series of statewide Welcome to Medicare in-person events, the team responded rapidly, engaging with residents in new ways and offering their free, one-on-one Medicare counseling remotely. The Delaware Medicare Assistance Bureau (DMAB) has provided more than 2,930 counseling sessions so far this year, saving beneficiaries more than $192,000 in premiums through application assistance.

“We are all facing new challenges due to COVID-19, and I’m proud that our DMAB team has found ways to communicate with Medicare beneficiaries and made Medicare education and empowerment more accessible despite the inability to offer in-person events,” said Insurance Commissioner Trinidad Navarro.

DMAB will engage in thousands of counseling sessions in the coming months, as Medicare Open Enrollment takes place October 15 through December 7. During this time, beneficiaries can make changes to their health insurance coverage and review existing coverage against other options. DMAB will offer virtual Open Enrollment appointments throughout this period, available via Webex, Duo, and Skype, as well as by phone. Residents are encouraged to register for a MyMedicare.gov account prior to their counseling session so that DMAB can generate personalized plan comparisons.

“Many people have questions about Medicare and don’t know where to start, and COVID-19 has only increased the stress of choosing the right healthcare plans. We are here to help people in Delaware deal with the complex and often confusing health insurance system,” said DMAB Director Lakia Turner, “and, we’re more accessible than ever through our new virtual programs.”

DMAB began to offer virtual Welcome to Medicare seminars in May, engaging 150 residents. The Virtual Medicare Seminar, which is now available on-demand online, educates participants on topics including Medicare benefits, supplemental insurance policies, Medicare Advantage plans, prescription drug coverage and details on signing up.

As Medicare Open Enrollment approaches, the department reminds residents to assess any contact during the open enrollment period to ensure it is from a known, credible source. The most frequent fraudulent contact occurs by phone, but residents should review communications carefully.

“If you are receiving contact regarding Medicare that you did not initiate, or contact not from one of your healthcare providers, it could be fraudulent,” said Commissioner Navarro. “Protect your Medicare Number like you do your Social Security number or bank account information, and never give it out to unknown or unexpected callers.”

DMAB has been awarded two significant grants during 2020. The 2020 State Health Insurance Assistance Program Base Grant provides $234,293 in federal funds to DMAB. This is a five-year grant, with annually awards in April. It is a primary source of funding for marketing and outreach, counseling, developing and training the volunteer network, and other strategic efforts. The MIPPA 2020 Grant awarded the bureau $43,270, which has and will assist the bureau’s outreach, education, and one-on-one beneficiary assistance programs over the next year for those beneficiaries who are likely to be eligible for the Low-Income Subsidy program (also called “Extra Help”) or Medicare Savings Programs.

The Delaware Medicare Assistance Bureau provides free one-on-one health insurance counseling for people eligible for Medicare. Residents can call DMAB at 1-(800) 336-9500 or (302) 674-7364 to set up a free confidential session. Counselors can assist with Medicare, Medicaid, Medigap (Medicare supplement insurance), long term care insurance, billing issues, prescription savings, and much more.


DMAB Releases 2015 Medicare Supplement Insurance Guide for Delaware Medicare Recipients

DMAB Releases 2015 Medicare Supplement Insurance Guide for Delaware Medicare Recipients

Dover, DE-The Delaware Medicare Assistance Bureau (DMAB) is pleased to announce that the 2015 Delaware Medicare Supplement Insurance Shopper’s Guide is now available in print. This popular guide is updated annually and includes price comparisons and toll-free telephone numbers for all Medigap policies sold in Delaware. Medicare supplement insurance, also called Medigap, is private insurance designed to supplement your Medicare coverage. The guide is also available at any time on the DMAB website, www.delawareinsurance.gov/DMAB.

While reviewing the rates on the Medigap plans in the 2015 guide, keep in mind that your gender and status as a smoker/non-smoker will directly affect your premiums. Please also be aware that listed rates may change during the year. It is recommended that you contact at least two or three companies directly and seek quotes to find the plan that provides you with the best value. It is important to note that the best time to purchase a Medigap policy is during your 6-month Medigap open enrollment.  This period automatically starts the month you’re 65 or older and enrolled in Medicare Part B, and once it’s over, you can’t get it again.  After six months have passed, companies selling these plans are not required to sell you a policy and may underwrite you.

DMAB was formerly known as ELDERinfo and still provides the same helpful services to Delaware’s Medicare recipients. While Medicare is a federal program, DMAB can help Delawareans with Medicare make sense of the complex health insurance system. All DMAB services are completely free. DMAB staff can assist with questions related to Medicare, Medigap, long-term care, and related financial assistance programs. Call DMAB at 1-800-336-9500 to receive a guide or to get help with your Medicare questions. Additional resources related to Medicare are available at  www.delawareinsurance.gov/dmab.

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Contact:  Jerry Grant

(302) 674-7303