Delaware Administrative Code
Title 18 - Insurance
1400 - Health Insurance Specific Provisions
1405 - Requirements for Fully Insured Multiple Employer Welfare Arrangements and Association Health Plans
Section 1405-3.0 - Definitions

The following words and terms, when used in this regulation, have the following meaning unless the context clearly indicates otherwise:

"Association" means any foreign or domestic association that complies with 18 Del.C. § 3506 (a)(1)-(6) and provides a health benefit plan that covers the employees of at least one employer that is either domiciled in Delaware or has its principal headquarters or principal administrative office in Delaware or covers a Delaware resident of a non-Delaware employer.

"Commissioner" means the Commissioner of the Delaware Department of Insurance.

"Department" means the Delaware Department of Insurance.

"Employee welfare benefit plan" or "welfare plan" means an employee welfare benefit plan or welfare plan as defined in 29 USC § 1002(1).

"Employee Retirement Income Security Act" or "ERISA" means the federal statute 29 USC Ch. 18.

"Fully Insured" means any association or MEWA health benefit plan coverage provided by a foreign or domestic insurer licensed to do business in Delaware in compliance with 18 Del.C. § 3506 and 29 USC § 1144(b)(6)(D).

"Health Benefit Plan" means a policy, contract, certificate, or agreement offered or issued by a health insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health services, as defined in 18 Del.C. § 903. The health benefit plan is issued to an association, to a trust, or to one or more trustees of a fund established, created, or maintained for the benefit of the members of one or more associations or a contract or plan issued by an association or trust or by a MEWA as defined in the Employee Retirement Income Security Act of 1974, 29 USC Ch. 18.

"Insurer" means any insurer, health service corporation, a health maintenance organization, or a managed care organization offering health insurance as defined in 18 Del.C. § 903. An insurer shall not offer a health benefit plan to an association or MEWA with covered lives in Delaware unless it possesses a certificate of authority from the Commissioner or unless the nature of its business in Delaware is such that it is exempt from this requirement under the provisions of 18 Del.C. § 506.

"Intermediary" shall mean an agent, broker, or other person who negotiates, solicits, or effectuates an agreement or contract to provide health care and/or medical coverage or benefits for any employer or employee in the state.

"Multiple employer welfare arrangement" or "MEWA" shall mean an arrangement which is established or maintained and offers to provide health care benefits or coverage to employees of two or more employers. Except, however, this regulation does not apply to multiple employer welfare arrangements which are exempt from state regulation under ERISA.

The following plans are excluded from the definition of MEWA: