State Government

Public Officers and Employees

CHAPTER 52C. Supplemental Insurance Program

§ 5290. Definitions.

As used in this chapter:

(1) “Carrier” means the supplemental income benefits carrier selected pursuant to § 5292 of this title.

(2) “Claims loss ratio” means claims payable as a percentage of premium income, or ratio of incurred losses and loss adjustment expenses to net premiums earned.

(3) “Committee” means the State Employee Benefits Committee as established by § 9602 of this title.

(4) “Employee” means an eligible “employee” as defined in §§ 5501 and 5201 of this title who elects to participate in the supplemental insurance program as specified in § 5293 of this title.

(5) “Income indemnity” means restoration to the participating employee of a loss by payment.

(6) “Premium” means the price of insurance protection for a specified risk for a specified period of time.

(7) “Supplemental insurance program” means voluntary insurance benefits designed to supplement existing major medical coverage where the payments are predetermined and paid regardless of other available coverage.

79 Del. Laws, c. 391, §  181 Del. Laws, c. 323, § 384 Del. Laws, c. 233, § 58

§ 5291. Payment of premium or subscription charges.

The participating employee shall pay all premium or subscription charges for the full cost of the supplemental insurance coverage policy, with no premium cost to the State.

79 Del. Laws, c. 391, §  1

§ 5292. Selection of the supplemental income benefits carrier.

The carrier shall be licensed in Delaware, selected by a proper vote of the Committee, and have adequate servicing facilities to carry out the terms of the contract as awarded by the Committee. The selected carrier shall maintain a claims loss ratio of not less than 60%.

79 Del. Laws, c. 391, §  1

§ 5293. Supplemental insurance program and design.

(a) The type of offered insurance shall be supplemental individual health insurance that is guaranteed renewable. This elective supplemental insurance program will entitle participating employees to receive income indemnity. Accident, cancer, and critical care and recovery, are to be required benefits of the offered supplemental policies. The Committee will determine whether premiums are to be deducted pretax or after-tax. The group monthly electronic invoice file with payment deduction details, associated reconciliation of premiums paid, and claims administration and payment due will be administered by the carrier and at their expense. The open enrollment for supplemental benefits policies will coincide with the open enrollment for state employee benefits beginning in 2015.

(b) The Committee shall annually review the supplemental individual health insurance program participation. Should the Committee determine that the volume of employee participation demonstrates a lack of interest or desire in accessing this program, the Committee may on or after July 1, 2020, in its discretion vote to restructure, modify, or terminate the program.

79 Del. Laws, c. 391, §  1