CHAPTER 348

FORMERLY

HOUSE BILL NO. 342

AN ACT TO AMEND TITLE 18 OF THE DELAWARE CODE BY ESTABLISHING A MEANS OF DETERMINING JURISDICTION OVER HEALTH CARE BENEFIT PROVIDERS.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

Section 1. Amend Title 18, Chapter 5 of the Delaware Code by adding a new subsection (d) to Section 505, which shall read as follows:

"(d) Notwithstanding any other provision of law, and except as provided herein, any person or other entity which provides coverage in this state for medical, surgical, chiropractic, physical therapy, speech pathology, audiology, professional mental health, dental, hospital, or optometric expenses, whether such coverage is by direct payment, reimbursement, or otherwise, shall be presumed to be subject to the jurisdiction and authority of the Commissioner unless the person or other entity show that while providing such services it is subject to the jurisdiction of another agency of this or another state, any subdivisions thereof, or the federal government. The jurisdiction and authority of the Commissioner shall be governed by the following provisions:

A person or entity may show that it is subject to the jurisdiction of another agency of this or another state, any subdivision thereof, or the federal government by providing the Commissioner the appropriate certificate, license or other document issued by the other governmental agency which permits or qualifies it to provide those services.

Any person or entity which is unable to show that it is subject to the jurisdiction of another agency of this or another state, any subdivision thereof, or the federal government, shall submit to an examination by the Commissioner to determine the organization and solvency of the person or the entity, and to determine whether or not such person or entity is in compliance with the applicable provisions of this code.

Any person or entity unable to show that it is subject to the jurisdiction of another agency of this or another state, any subdivision thereof, or the federal government shall be subject to all appropriate provisions of this code regarding the conduct of its business.

Any production agency or administrator which advertises, sells, transacts, or administers coverage in this state described in subsection (d) above which is provided by any person or entity described in paragraph (2) of this subsection shall, if that coverage is not fully insured or otherwise fully covered by an admitted life or disability insurer, non-profit hospital service plan, or non-profit health care plan, advise any purchaser, prospective purchaser, and covered person of such lack of insurance or other coverage.

Any administrator which advertises or administers coverage in this state, described in subsection (d), which is provided by any person or entity described in paragraph (2) shall advise any production agency of the elements of the coverage including the amount of "stop-loss" insurance in effect."

Approved July 17. 1984.