Another banner year for consumer protection and insurer competition

In 2023, the Delaware Department of Insurance’s 101 team members served Delaware residents and seniors, attracted new companies, oversaw expansions of coverage and enhanced competition, and contributed substantial funds to the state. Today’s data release details how each team contributed to Delaware’s strong insurance environment.

“Each year, our team gathers and reports data on our efforts to give residents a look at our daily work,” said Insurance Commissioner Trinidad Navarro. “And while the numbers themselves are impressive, within them are tens of thousands of stories. Stories of finding affordable coverage for the first time, stories of storms and fires, stories of injustice, investigation, and resolution, and above all, a story of change. Our state is changing, and our department is changing with it to ensure we continue to protect our consumers and offer them a robust, affordable, competitive insurance market.”

The year began with the announcement of a record-setting Open Enrollment on the Delaware Health Insurance Marketplace, where 35,000 residents got covered, and 6,000 were eligible for plans costing $10 or less per month. As recently as 2022, Delaware consumers only had one insurer and 12 plans to choose from – but during 2023 enrollment, they had four carriers and more than 50 plans offering coverage. Premiums in the individual market have decreased roughly 12% since 2019.

DOI welcomed yet another new carrier to the Marketplace in 2023, and indications are that enrollment for 2024 has again broken enrollment records with likely more than 40,000 enrollees.

Health insurance rates are submitted alongside affordability standards data to the department’s Office of Value-Based Health Care Delivery, which endeavors to support a robust, high-quality primary care environment. As a result of this work, annual primary care investment is projected at over $40 million, an increase of nearly $13 million or 44% year over year. This includes a projected $7 million in direct, prospective payments to more than 775 providers engaged in care transformation.

In addition to supporting healthcare providers, the work of the department also provides substantial funding to the state. For the 2023 calendar year, the department’s work resulted in about $189 million in funds for the state and its funds, including $113 million for the General Fund, and $44.7 million for fire companies.

Strong results were again reported by resident-facing programs. Consumer Services staff processed a total of 4,228 complaints and inquiries. The Medicare Assistance Bureau hosted and participated in 66 public events, and held more than 5,000 one-on-one counseling sessions. Medicare beneficiaries saved an estimated $2.08 million dollars because of the free assistance offered by this team, an increase of over half a million dollars from last year. Helping residents address claim settlement issues outside of court, the Legal Division reported that of 419 cases, 236 settled pre-hearing. Completed arbitration cases resulted in awards totaling more than $611,000. The department also moved to a new office in New Castle County, which offers much improved accessibility to consumers, while also saving the department over $200,000.

Delaware continued to be a national presence in insurance regulation, with Commissioner Navarro being elected Chair of the Northeast Zone of the National Association of Insurance Commissioners. His tenure chairing the National Anti-Fraud Task Force, and Delaware’s leadership on the Improper Marketing of Health Plans Working Group has resulted in improved coordination of efforts across states, and progress in the drafting of an improved model law related to producer licensing. Locally, the Commissioner and staff participate in numerous committees, including the Behavioral Health Crisis Services Board, Delaware Health Care Commission, Foster Youth Drivers’ License and Insurance Working Group, EARNs Board, Non-Acute Long Stay Task Force, Plans Management Board, Primary Care Reform Collaborative, Retiree Healthcare Benefits Advisory subcommittee, and the State Employee Benefits Committee (SEBC).

In 2023 the seventh consecutive decrease in workers’ compensation insurance rates was approved, a double-digit average drop of 13.85% in the residual market and 10.03% in the voluntary market. These lower rates are just one component of several department efforts to help businesses. Nearly 1,000 employers are saving even more on their premiums by participating in the department’s Workplace Safety Program, saving approximately $5.6 million on premiums through safety credits.

Market Conduct staff completed 61 insurer interrogatories, 72 Level 1 market analyses, and 5 exams including 3 introductory PBM examinations. 13 examinations remain in progress.

The most recent data available from the Bureau of Examination, Rehabilitation and Guaranty shows oversight of the financials of 149 domestic companies that manage $769 billion in assets, and more than 2,149 other companies operating in the state. This represents 8 new domestics, 76 new licenses, and an increase of one billion dollars in assets managed. The team completed 34 financial examinations and have 22 exams in progress.

The Fraud Bureau processed 631 referrals, closing 12 criminal cases with 44 charges. They collected $15,525 in civil penalties last year and closed 574 cases. 607 cases are open.
Life and Health staff reviewed 5,782 filings, rates, forms, and advertisements. The Property and Casualty team reviewed 26,915 filings, rates, forms, and rules. In addition, the department issued 57,216 licenses in 2023, bringing total licensees to 253,438.

This past year, the Captive Bureau announced the launch of Delaware Captives 2.0 in conjunction with the Delaware Captive Insurance Association to continue to innovate and compete with other domiciles. 43 new captives were licensed in 2023, for a total of 670 licensed captives.

The department led and engaged with dozens policy efforts with partners in the legislature. Legal staff processed 15 new bulletins and 10 revised or reissued bulletins, 5 new regulations, and 4 exempt orders to regulations.

Staff also participated in outreach events, including the Positively Dover African American Festival, Clayton Fire Prevention Open House, Dover Days, Down Syndrome Walk, Middletown Peach Festival, Milford Freedom Walk Festival, New Castle Ice Cream Festival, the 55+ Expo, and of course, the Delaware State Fair. In addition to robust contributions to the Delaware Employees’ Charitable Campaign, the Department also participates in charitable events including blood drives, food insecurity donations, and breast cancer awareness.

Process and regulatory changes developed in partnership with the Delaware Captive Insurance Association

Insurance Commissioner Trinidad Navarro and the Delaware Captive Insurance Association (DCIA) are proud to announce a series of process and regulatory improvements intended to ensure Delaware remains a top domicile for businesses seeking to form captive insurance companies. The news was shared at DCIA’s Fall Forum last week, the premier event for industry leaders.

“As global leaders in captive insurance, we recognize that we must continue to explore improvement, innovation, and industry insight,” said Insurance Commissioner Trinidad Navarro. “This industry is an important economic engine in our state, and I look forward to continuing to foster its expansion.”

After robust stakeholder engagement, the department issued Captive Bulletin No. 14, which outlines the Bureau of Captive & Financial Insurance Products’ requirements for captives formed to write corporate “Side A” directors’ and officers’ (D&O) coverage for Delaware corporations. This progress was made possible by the passage of SB 203 (2022). It is expected that this will help companies access more affordable coverage and increase Side A D&O capacity.

The department also issued revised Captive Bulletin No. 12, adopting a more flexible approach for certain captive applicant’s capitalization requirements, including allowing use of brokerage accounts in certain circumstances. Additionally capital and surplus requirements have been recalibrated to place more emphasis on consulting actuaries’ adverse case projections.

Several process changes are anticipated to improve approval timelines and speed to market. Unless otherwise noticed, review of initial application filings will decrease from a goal of 45 days to 30 days. Conditional licensure applications typically see a significant spike toward the end of the year. Moving forward, those applications received after November 1 each year will be reviewed within 80 days of submission. All routine requests for approvals, such as dividends, business plan changes, statutory dormancy, and changes in approved service providers, will now be reviewed within ten days of receipt. Additionally, captives will now be able to seek contingent Bureau approval for actions requiring Board approval or ratification.

Michael Teichman, President of the Delaware Captive Insurance Association, said “Delaware has been a top global captive domicile since revamping its captive insurance statute almost 18 years ago. While we believe Delaware continues to have much to offer, we recognize other domiciles are not standing still, and we cannot rest on our laurels. Over the past year we have enjoyed the opportunity to work with Commissioner Navarro and Bureau Director Stephen Taylor to develop these helpful and timely domicile improvements.”

Captive insurance companies are owned by the entities that they insure and are usually formed by businesses to better manage the cost and administration of their insurance coverage. Delaware is the world’s fifth largest and the third largest U.S. captive domicile. It is one of four global domiciles recognized by the International Center for Captive Insurance Education as ICCIE Trained. To learn more, visit captive.delaware.gov.

The Delaware Captive Insurance Association is a Delaware non-stock not-for-profit corporation formed in 2005 to serve as the unified voice of the captive insurance industry in Delaware and to support the development and growth of the industry through marketing, networking, education, and legislative initiatives.

New rates will be effective December 1

UPDATE: Following a review of the Delaware Compensation Rating Bureau (DCRB) filing by independent actuaries and a public hearing with DCRB and the State’s Ratepayer Advocate, the final Workers’ Comp rates have been approved. Commissioner Navarro is proud to announce that additional decreases have been negotiated from the initial filing:
Residual Market: Average decrease of 13.85%
Voluntary Market: Average decrease of 10.03%

Insurance Commissioner Trinidad Navarro announced today that workers’ compensation insurance rates will decrease for the seventh year in a row, effective December 1, 2023.

“From the start of my administration to today, Delaware’s local businesses have never seen a worker’s compensation rate increase. We started with some of the highest costs in the country, and endured a pandemic, yet our reforms are still proving themselves to be effective. Most importantly, businesses are doing their part by committing to reducing risk through employee protections and creating safe work environments,” said Insurance Commissioner Trinidad Navarro. “I’m proud to announce yet another decrease, Delaware businesses deserve it.”

This year’s decrease in worker’s compensation insurance rates continues the reversal of voluntary and residual market trends. With the residual market expected to see a greater rate decrease, it shows that companies who previously could only obtain coverage in this ‘last resort’ market, due to cost, high risk, or claims history, can now obtain traditional voluntary market coverage. This is the second year of this trend, which indicates substantial improvement in coverage affordability and employee safety.

Workers’ compensation insurance provides coverage when an employee is hurt on the job and can provide medical coverage as well as payments for lost wages if a person is unable to work due to their injury. Lower premiums don’t change the amount of compensation an injured employee receives.

Final rates are expected to be announced later this fall, following a confirmation of the Delaware Compensation Rating Bureau (DCRB) filing by independent actuaries, and a public hearing with DCRB and the State’s Ratepayer Advocate. Actual savings will vary by policy.

These lower rates are just one component of several department efforts to help businesses. More than 1,100 employers are saving even more on their premiums by participating in the department’s Workplace Safety Program, saving approximately $6.9 million last year. Eligible businesses can earn up to a 19% discount on their insurance by successfully undergoing annual safety inspections and complying with recommendations. Importantly, employees may also benefit directly from employer-based safety goals – for example, a workplace may offer bonuses if there are no injuries in a given timeframe and pass on the savings to workers.

Businesses eligible for the Workplace Safety Program are notified each year seven months prior to their renewal date. Organizations interested in participating can access questionnaires online and contact safety@delaware.gov to begin the process. The department has updated the Inspection Fee Schedule for program participants, as indicated on the questionnaire. Workplace Safety Program inspectors are independent safety professionals contracted by the department, not state employees or OSHA. Only benefits can be gained by participating; failure to qualify cannot be the basis for premium increases or sanctions imposed by other safety officials.

View the DCRB website

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.

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]