Del. Code tit. 18 § 2503

Current through 2024 Legislative Session Act Chapter 494
Section 2503 - [Effective Until 1/1/2027] Making of rates
(a) Rates must be made in accordance with the following provisions:
(1) Manual, minimum, class rates, rating schedules or rating plans shall be made and adopted, except in the case of specific inland marine rates on risks specially rated;
(2) Rates shall not be excessive, inadequate or unfairly discriminatory;
(3) Due consideration shall be given:
a. To past and prospective loss experience within and outside this State;
b. To the conflagration and catastrophe hazards;
c. To a reasonable margin for underwriting profit and contingencies;
d. To dividends, savings or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members or subscribers;
e. To past and prospective expenses both countrywide and those specially applicable to this State;
f. To all other relevant factors within and outside this State; and
g. In the case of fire insurance rates, consideration shall be given to the experience of the fire insurance business during a period of not less than the most recent 5-year period for which such experience is available;
(4) The systems of expense provisions included in the rates for use by any insurer or group of insurers may differ from those of other insurers or groups of insurers to reflect the requirements of the operating methods of any such insurer or group with respect to any kind of insurance, or with respect to any subdivision or combination thereof for which subdivision or combination separate expense provisions are applicable;
(5) Risks may be grouped by classifications for the establishment of rates and minimum premiums. Classification rates may be modified to produce rates for individual risks in accordance with rating plans which establish standards for measuring variations in hazards or expense provisions or both. Such standards may measure any differences among risks which may have a probable effect upon losses or expenses;
(6) The Commissioner shall require a reduction in rates for a 3-year period for any person who voluntarily attends and successfully completes a motor vehicle accident prevention course that is approved by the Division of Motor Vehicles.
a. A motor vehicle accident prevention course under this paragraph (a)(6) of this section must educate an individual taking the course on traffic stops by a law-enforcement officer as required under § 2713(e) of Title 21. A motor vehicle accident prevention course under this paragraph (a)(6) of this section must include at least 2 questions on any test given to an individual taking the course to test the individual's knowledge of traffic stops by a law-enforcement officer.
b. Motor vehicle accident prevention course instructors that have been certified by the Division of Motor Vehicles are entitled to the same reduction in rates as those individuals that have successfully completed a motor vehicle accident prevention course, in the manner set forth in regulations promulgated under this section.
c. The reduction must be for any individually owned vehicle classified as a private passenger vehicle and must be in proportion to the number who have completed the course in the event that not all members of a group have completed the course.
d. Voluntary attendance does not include any attendance ordered as permitted by a court or required by the Division of Motor Vehicles pursuant to any violations of Title 21;
(7) The Commissioner shall require a reduction in rates for a 3-year period for any person who voluntarily attends and successfully completes a motorcycle rider course that is approved by the Division of Motor Vehicles.
a. A motorcycle rider course under this paragraph (a)(7) of this section must educate an individual taking the course on traffic stops by a law-enforcement officer as required under § 2713(e) of Title 21. A motorcycle rider course under this paragraph (a)(7) of this section must include at least 2 questions on any test given to an individual taking the course to test the individual's knowledge of traffic stops by a law-enforcement officer.
b. Motorcycle rider course instructors that have been certified by the Division of Motor Vehicles must be entitled to the same reduction in rates as those individuals that have successfully completed a motorcycle rider course, in the manner set forth in regulations promulgated under this section.
c. The reduction must be for any individually owned vehicle classified as a motorcycle and licensed for use on the streets and highways of this State.
d. Voluntary attendance does not include any attendance ordered as permitted by a court or required by the Division of Motor Vehicles pursuant to any violations of Title 21;
(8) The Commissioner shall require insurers to file an actuarially justified reduction in rates for a 3-year period if all operators of a vessel voluntarily attend and successfully complete a boating safety education course which is approved by the Department of Natural Resources and Environmental Control for the purposes of § 2221 of Title 23. The reduction shall be for any individually owned vessel used exclusively for noncommercial purposes. Voluntary attendance shall not include any attendance ordered as permitted by a court or required by the Department of Natural Resources and Environmental Control pursuant to any violations of Title 23;
(9) Rate filings concerning automobile collision insurance shall provide for a credit of 5 percent of annual premiums for such coverage for any individually owned vehicle classified as a private passenger vehicle owned by employees participating in an approved Travelink Traffic Mitigation Act program created pursuant to subchapter IV of Chapter 20 of Title 30;
(10) An insurer authorized to do business in Delaware cannot increase a renewal rate for a personal automobile insurance policy based solely on an insured having attained the age of 75 or older;
(11) With respect to personal automobile insurance for an existing insured, an insurer authorized to do business in Delaware may not charge the insured a higher rate solely based upon a change in his or her marital status due to the death of a spouse.
(12)
a. Rate filings for health benefit plans may not include aggregate unit price growth for nonprofessional services that exceed the following:
1. In 2022, the greater of 3 percent or Core CPI plus 1 percent.
2. In 2023, the greater of 2.5 percent or Core CPI plus 1 percent.
3. In 2024, 2025, and 2026, the greater of 2 percent or Core CPI plus 1 percent.
b. For purposes of this paragraph (a)(12) and paragraphs (a)(13) and (a)(14) of this section:
1. "Core CPI" means the average of the 12 preceding bimonthly indices calculating the over-the-year changes of the Consumer Price Index for All Urban Consumers in the Philadelphia-Camden-Wilmington Area, All Items Less Food & Energy, developed by the United States Bureau of Labor Statistics.
2. "Health benefit plan" means as defined under § 3342A(a)(3)a. and § 3559(a)(3)a. of this title.
3. "Inpatient hospital" means non-capitated facility services for medical, surgical, maternity, skilled nursing, and other services provided in an inpatient facility setting and billed by the facility.
4. "Nonprofessional services" means services categorized as inpatient hospital, outpatient hospital, and other medical services. "Nonprofessional services" does not include professional services.
5. "Other medical services" means non-capitated ambulance, home health care, durable medical equipment, prosthetics, supplies, and the facility component of vision exams, dental services, and other services when billed separately from the professional component.
6. "Outpatient hospital" means non-capitated facility services for surgery, emergency services, lab, radiology, therapy, observation, and other services provided in an outpatient facility setting and billed by the facility.
7. "Professional services" includes primary care, dental, specialist, therapy, the professional component of laboratory and radiology, and similar services, other than the facility fee component of hospital-based services.
c. The Commissioner shall annually determine the Core CPI by March 31 of the applicable rate filing year using the bimonthly indices ending with the bimonthly index issued in January of the applicable rate filing year.
d. The Commissioner shall annually communicate, under § 312(c) of this title, the determination under paragraph (a)(12)c. of this section to carriers.
(13) All rate filings for health benefit plans subject to § 3342B and § 3556A of this title must reflect the spending requirements under § 3342B(b)(3) and § 3556A(b)(3) of this title.
(14) All rate filings by carriers with health benefit plans that cover more than 10,000 members across all fully-insured products must reflect progress with achieving the targets described in § 9903(a)(1) of Title 16, and, at a minimum, must have 50% of total cost of care tied to an alternative payment model contract that meets the Health Care Payment Learning and Action Network (HCP-LAN) Category 3 definition for shared savings or shared savings with downside risk by 2023, with a minimum of 25% total cost of care covered by an alternative payment model contract that meets the definition of HCP-LAN Category 3B, which includes only contracts with downside risk.
(b) Nothing in this section shall be taken to prohibit as unreasonable or unfairly discriminatory the establishment of classifications or modifications of classifications or risks based upon size, expense, management, individual experience, purpose of insurance location or dispersion of hazard or any other reasonable considerations provided such classifications and modifications apply to all risks under the same or substantially similar circumstances or conditions.
(c) Except to the extent necessary to meet the provisions of subdivisions (2) and (9) of subsection (a) of this section, uniformity among insurers in any matters within the scope of this section is neither required nor prohibited.

18 Del. C. § 2503

Amended by Laws 2021, ch. 322,s 1, eff. 6/14/2022, exp. 1/1/2027.
Amended by Laws 2021, ch. 237,s 4, eff. 10/1/2021.
Amended by Laws 2017, ch. 350,s 5, eff. 8/1/2019.
Amended by Laws 2017, ch. 108,s 2, eff. 5/1/2018.
Amended by Laws 2013, ch. 250,s 1, eff. 12/9/2014.
18 Del. C. 1953, § 2503; 56 Del. Laws, c. 380, § 1; 63 Del. Laws, c. 175, §1; 67 Del. Laws, c. 147, §1; 67 Del. Laws, c. 160, §§3, 4; 70 Del. Laws, c. 122, § 1.;
Section 2 of Act Chapter 322 provides that for purposes of rate filing year 2022, the Core CPI under § 2503(a)(12)a.1. of Title 18 of the Delaware Code is 4.5%.
This section is set out more than once due to postponed, multiple, or conflicting amendments.