$21.5 Million in Health Insurance Rebates for Individuals and Small Businesses

Thousands of Highmark 2019 plan participants and groups to receive checks

After announcing a reduction of Delaware Health Insurance Marketplace rates for the upcoming enrollment year, Insurance Commissioner Trinidad Navarro has more good news for residents who purchase insurance on the Delaware Health Insurance Marketplace, those who purchase Highmark Blue Cross Blue Shield Delaware plans outside of the exchange in the individual market, and for Highmark small group policyholders, announcing more than $21.5 million in rebates for 2019 participants.

“Now, more than ever, we need to make sure that every resident and small business can afford the health insurance they need for their families and employees. These rebates, combined with the ACA health insurance rate reduction for the coming year, do just that,” said Commissioner Navarro. “This is just one of many ways we are working to reduce the cost-of-care our residents experience in the health care system.

For the first time in the history of Delaware’s individual health insurance market, more than $12.6 million will be returned to 19,273 policyholders, with the average rebate being $656. Highmark small groups, often small businesses, will receive more than $8.8 million in cumulative return. 2,779 groups will receive an average rebate of $3,198, with more than 175 groups receiving rebates over $10,000. Employers can consider using these dollars to enhance benefits, reduce premiums for employees in future policy years or provide refunds directly to group health plan participants.

Communications will be sent to policyholders in September and checks for both individual policyholders and small groups will be sent the week of September 21. Those in the individual market with rebate questions can contact Highmark at 800-544-6679. Small group employers with rebate questions can contact their insurance producer, or Highmark at 800-241-5704.

These rebates are required by the Delaware Department of Insurance according to Medical Loss Ratio (MLR) measurements set by the Affordable Care Act, which are meant to ensure that insurers are spending a majority of premiums on health claims and clinical services, not taking those dollars for profit or administrative expenses. The rebate system creates balance when data shows that this ratio was off in a previous year. Not every policy will receive a rebate. MLR review for the 2020 plan year will shine a light on changes in insurance usage due to COVID-19 and will be released in 2021.

On August 31, Commissioner Navarro announced the Delaware Health Insurance Marketplace would see an average decrease in rates of 1% for individual plans. Highmark small group plans will see an average premium decrease of 3%.


Commissioner Navarro Statement on Sixth Modification to State of Emergency

In consultation with the Delaware Department of Insurance, Governor John Carney today issued a sixth modification to the state of emergency that requires that insurers cease cancellations or nonrenewals of insurance policies due to nonpayment throughout the duration of the declared Delaware State of Emergency for those residents and business owners who are experiencing a loss of income. In declaring a Public Health Emergency earlier this week, the Governor specified that health insurers are to waive all prior authorization constraints for lab testing and future treatment of COVID-19. Commissioner Navarro previously recommended insurers take these actions in a bulletin to the industry.

“We are grateful for Governor John Carney’s leadership during the COVID-19 crisis. Whether it is ensuring care without delay by removing prior authorizations in the short-term, or limiting the long-term effects of the virus’s economic impact by helping people keep their insurance, this thoughtful, detailed approach is just what our state needs,” said Commissioner Navarro.

Delaware’s insurance carriers will freeze cancellations and nonrenewal of policies that might have otherwise occurred due to delays in payments through the duration of the state of emergency for individuals who have been laid off or fired due to the state of emergency or organizations who have had to close or significantly reduce business. A carrier would now be required to seek a court order before they could cancel or nonrenew any health, life, disability, property, auto, and commercial/business insurance policies.

In addition to the immediate assistance, this action helps to reduce the long-term impact of the virus on insurance, because if policies were not renewed or were cancelled, it could have hindered future insurance policy approvals or increased premium costs for those individuals and businesses due to the cancellation or nonrenewal creating a lapse of insurance.

Read the Governor’s Emergency Declaration


Delaware Issues RFP for Office of Value-Based Health Care Delivery

Delaware’s Department of Insurance is pleased to announce that it is actively recruiting for a qualified independent contractor to staff and run its new Office of Value-Based Health Care Delivery. The Office will assist the Insurance Commissioner and Delaware’s Primary Care Reform Collaborative in evaluating primary care accessibility and affordability statewide.

“Reducing health care costs in Delaware is a key priority of my administration,” said Insurance Commissioner Trinidad Navarro. “The team leading our Office of Value-Based Health Care Delivery needs to possess a high level of expertise in health care transformation and innovation. Together with the Primary Care Reform Collaborative, we intend to identify quantitative tools that will help increase the availability of high quality, cost-efficient health insurance products that have stable, predictable, and affordable rates.”

Earlier this year, members of the General Assembly passed Senate Substitute 1 for Senate Bill No. 116, in order to create the Office. The Office was a recommendation of the Primary Care Reform Collaborative, which is tasked with evaluating the high costs of care in Delaware. In the months since passage, the Collaborative has been working hard to develop recommendations to strengthen Delaware’s primary care system.

“The legislature’s consideration of pro-consumer bills has allowed us to continue to foster an environment where residents are prioritized over profits,” said Leslie W. Ledogar, Esq, the Commissioner’s representative within the working group. “The Office of Value-Based Health Care Delivery epitomizes that vision, and we are grateful for everyone who spent time working on this effort.”

The Request for Proposal may be downloaded from the Office of Management and Budget website. Applicant questions should be directed to the Department’s Regulatory Specialist Leslie W. Ledogar, Esq.


Workers’ Compensation Rates Decrease Third Year in a Row

DOVER, DE – Delaware Insurance Commissioner Trinidad Navarro is pleased to announce that there will be another decrease in workers’ compensation insurance rates, effective December 1, 2019.

“I am delighted to approve a decrease in workers’ compensation rates in Delaware for the third year in a row,” stated Commissioner Navarro. “These continued decreases mean significant savings for Delaware businesses both large and small and continues to be an incentive for smaller businesses to relocate to Delaware and employ more Delawareans.”

The Delaware Compensation Rating Bureau workers’ compensation rate decreases were approved on Tuesday, October 8, 2019, after review by the Department of Insurance’s (“Department”) independent actuaries and the State’s Ratepayer Advocate and a public hearing before the Honorable Joshua Martin.  The decreases are an average -12.75% for the residual market and an average of -13.29% for the voluntary market.  It is important to keep in mind that these are average changes and actual changes to a particular policy may vary depending on, among other things, class codes or insureds.

Commissioner Navarro added further, “The continued hard work of everyone involved in this process especially over the last few years continues to ensure that the process is transparent and efficient.  I am also pleased that this is the first year that all actuaries reviewing this filing agreed, not only that another significant drop in workers’ compensation rates was warranted, but that the filing as submitted to the Department needed no changes.  Lastly, I want to again acknowledge the Department’s Workplace Safety Program and its dedicated staff for their work in helping Delaware businesses save up to 19% on premiums for providing a safe working environment.”

Employers who wish to take advantage of the Delaware Workplace Safety Program are encouraged to visit its webpage at www.insurance.delaware.gov/workplacesafety, or call our office directly at (302) 674-7377.

The approved amended DCRB filing No. 1902 can be found at http://www.dcrb.com/shared/d_contents.htm.

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Contact: Tanisha L. Merced, Esq.

Deputy Insurance Commissioner

Office:    (302) 674-7300

                                                           

Delaware Department of Insurance

http://www.insurance.delaware.gov

Dover Office: 302-674-7300

Consumer Services Division: 1-800-282-8611


ACA Marketplace Rates to Decrease 19% in Delaware for Plan Year 2020

Dover, DE – Insurance Commissioner Trinidad Navarro officially announced the final approval of the 2019 Affordable Care Act (“ACA”) rates. Highmark Blue Cross Blue Shield of Delaware (“Highmark BCBSD”), the only insurer currently on the Marketplace, originally proposed a rate decrease of 5.8% for its 2019 individual Marketplace business. Commissioner Navarro, ultimately approved a decrease of 19%, after the implementation of a state-run reinsurance program, the first decrease ever since the Marketplace opened in 2013.

The approved decrease was a result of federal approval for the State of Delaware to implement a state-run reinsurance program as established pursuant to the 1332 State Innovation Waiver Application (“Waiver”). Under this program, individual market policies that meet certain minimum criteria, as set forth in the Waiver, will be eligible for reimbursement from a state-administered fund. The fund will be financed through a 1% assessment on the individual, small and large group market premium amounts for all health insurance carriers operating in those markets in Delaware. The assessment will take place annually and may vary depending on the federal government’s actions on the Health Insurance Industry Fee.

“I am happy to announce the first rate decrease in Delaware since the beginning of the Health Insurance Marketplace. In spite of the many efforts in Washington to dismantle the Affordable Care Act, we have been able to work with our state counterparts and stakeholders to give Delaware policyholders much-needed premium relief. I thank Secretary Walker for the work she and her team at DHSS put into seeing the Waiver across the finish line.”

Because this year’s filing may result in lower costs for many consumers, the Department urges consumers to examine their rates and reapply for coverage through the Marketplace.

Presently, approximately 23,000 Delawareans have health insurance through the Affordable Care Act and may be affected by these rates.

Please be advised that the proposed rate decrease will not apply to Delawareans on Medicare, Medicaid, or those with group or individual policies outside of the Marketplace.

 

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Contact: Vince Ryan

Office: (302) 674-7303

Email: vince.ryan@delaware.gov

                                                          

Delaware Department of Insurance

http://www.insurance.delaware.gov

Dover Office: 302-674-7300

Consumer Services Division: 1-800-282-8611