Delaware General Assembly


CHAPTER 176

FORMERLY

HOUSE BILL NO. 102

AS AMENDED BY HOUSE AMENDMENT NO. 2

AN ACT TO AMEND TO AMEND CHAPTER 38, TITLE 18 OF THE DELAWARE CODE, RELATING TO DENTAL SERVICE BENEFITS BY DENTAL PLAN ORGANIZATIONS, TO ASSURE FREEDOM OF CHOICE FOR DENTAL SERVICE CONSUMERS AND OPEN ENROLLMENT IN DENTAL PLANS FOR QUALIFIED DENTISTS, AND CERTAIN OTHER IMPROVEMENTS, INCLUDING AN ADVISORY COUNCIL.

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

Section 1. Amend §3804(a), Chapter 38, Title 18, Delaware Code, by adding thereto a new subsection (10) to read as follows:

"(10)(a) Each employer or other organization which employs or has 25 or more

employees or members during the full preceding calendar year and which contributes to a dental plan organization contract which restricts the covered persons in selecting the providers of dental services to a single provider or limited number of providers, shall also offer its employees and their eligible dependents and members and members' eligible dependents at the time a dental benefits plan is offered or renewed the option of selecting alternative coverage which permits covered persons to obtain dental services from any licensed dentist.

(b) An employer or other organization shall be required to pay for or contribute towards the provision of alternative coverage an amount equal to the premium or cost which it pays or contributes to the dental plan organization contract which limits the number of providers of dental services.

(c) Within 120 days of the effective date of this Act, the Commissioner of the Department of Insurance shall promulgate rules and regulations necessary to effectuate the purpose of this Act, including procedures for notice to covered persons, employers and other organizations of the provisions of this Act."

Section 2. Amend Chapter 38, Title 18, Delaware Code, by adding a new §3823 to read as follows:

§3823. Advisory Council

To assist the Commissioner in drafting appropriate rules and regulations and in generally administering and enforcing the purposes and provisions of this Chapter, the Governor shall appoint an Advisory Council. The Advisory Council shall consist of three dentists admitted to the practice of dentistry in this State and three other State residents, one of whom shall be an employer; one of whom shall be a representative of the insurance industry and one of whom shall be a consumer, each of whom shall serve a term of three years. The Governor shall consult with the Commissioner and the Delaware State Dental Society before making any appointment to the Advisory Council. The members shall serve without compensation other than reimbursement of necessary expenses by the Insurance Department. The Advisory Council shall meet at such times and places as the members deem necessary and as requested by the Commissioner."

Section 3. If all or any part of these Amendments to Chapter 38, Title 18, Delaware

Code, shall be found invalid for any reason, such determination shall not affect, impair or invalidate any other Section, term or provision of said Chapter, and the remaining Sections, terms and provisions shall remain in full force and effect.

Section 4. This Act shall become effective ninety days subsequent to enactment, during which interim period the Insurance Commissioner shall promulgate those rules and regulations immediately necessary to effectuate the purposes of this Act. This Act and such rules and regulations shall apply to all new dental plans reviewed thereafter and to all existing dental plans at the time of the next annual review of the applicable certificate of authority pursuant to §3804(c), Chapter 38, Title 18, Delaware Code.