SB 107 — AN ACT TO AMEND TITLE 18, TITLE 29, AND TITLE 31 OF THE DELAWARE CODE RELATING TO INSURANCE COVERAGE OF INSULIN PUMPS.

Rep.Sen.

BentzPinkney HOUSE& OFRep. REPRESENTATIVES 151st GENERAL ASSEMBLY HOUSE AMENDMENT NO.

1Bentz TOSens. SENATE BILL NO.

107Brown, AMENDGay, SenateHansen, BillMantzavinos, No.Sokola, Sturgeon, Townsend, Walsh;

107Reps. by deleting lines 12 through 13 in their entirety and inserting in lieu thereof the following:

“(d)Baumbach, ThisBush, sectionKowalko, doesLambert, notS. apply to any of the following:

(1)Moore, Accident-only,Morrison, specifiedWilson-Anton disease,DELAWARE hospitalSTATE indemnity,SENATE Medicare151st supplement,GENERAL long-termASSEMBLY care,SENATE disabilityBILL income,NO. or other limited benefit health insurance policies.

(2)107 AAN highACT deductibleTO healthAMEND planTITLE if18, providingTITLE coverage29, underAND subsectionTITLE (b)31 ofOF thisTHE sectionDELAWARE wouldCODE causeRELATING theTO planINSURANCE toCOVERAGE failOF toINSULIN bePUMPS. treated as a high deductible health plan under § 223(c)(2) of the Internal Revenue Code.

(3)BE AIT catastrophicENACTED healthBY planTHE ifGENERAL providingASSEMBLY coverageOF underTHE subsectionSTATE (b)OF ofDELAWARE: this section would cause the plan to fail to be treated as a catastrophic plan under § 1302(e) of the Patient Protection and Affordable Care Act, 42 U.S.C.

§Section 18022(e).”.1.

FURTHERAmend AMENDChapter Senate33, BillTitle No.18 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

107§ by3344C. deleting lines 27 through 28 in their entirety and inserting in lieu thereof the following:

“(d)Coverage Thisfor sectioninsulin doespumps. not apply to any of the following:

(1)(a) Accident-only,For specifiedpurposes disease,of hospitalthis indemnity,section, Medicare“insulin supplement,pump” long-termmeans care,a disabilitysmall, income,portable ormedical otherdevice limitedthat benefitis healthapproved insuranceby policies.the U.S.

(2)Food Aand highDrug deductibleAdministration health plan if providing coverage under subsection (b) of this section would cause the plan to failprovide tocontinuous besubcutaneous treatedinsulin asinfusion. a high deductible health plan under § 223(c)(2) of the Internal Revenue Code.”.

SYNOPSIS(b) ThisAll amendmentindividual createshealth exemptionsinsurance policies, contracts, or certificates that are delivered, issued for 2delivery, typesrenewed, ofextended, healthor plansmodified becausein this requirementState conflictsshall withprovide thecoverage currentfor federala requirementsmedically fornecessary catastrophicinsulin pump at no cost to a covered individual, including deductible payments and highcost-sharing amounts charged once a deductible healthis plans.met.

Both(c) exemptionsExcept applyas onlyprovided ifunder subsection (b) of this requirementsection, conflictsnothing thein federalthis lawsection governingprevents the typeoperation of healtha plan.policy provision required by this section as a deductible, coinsurance, allowable charge limitation, coordination of benefits, or a provision restricting coverage to services by a licensed, certified, or carrier-approved provider or facility.

A(d) highThis deductiblesection healthdoes plannot (HDHP)apply isto anaccident-only, insurancespecified policydisease, thathospital hasindemnity, aMedicare highersupplement, deductiblelong- andterm lowercare, premiumsdisability thanincome, traditionalor other limited benefit health insurance plans.policies.

The(e) InternalThis Revenuesection Codeapplies establishesto theall requirementspolicies, forcontracts, HDHPs,or whichcertificates includeissued, minimumrenewed, deductiblesmodified, andaltered, maximumamended, out-of-pocketor expenses.reissued after December 31, 2021.

UnderSection the2. Affordable Care Act, HDHPs may provide preventive care benefits without a deductible or other requirements, if the benefit is described as preventive care under § of the Social Security Act or determined to be preventive care in guidance issued by the Department of the Treasury.

TheAmend mostChapter recent35, IRSTitle guidance18 regardingof preventivethe careDelaware benefitsCode thatby aremaking permitteddeletions toas beshown provided by HDHPsstrike includesthrough insulinand butinsertions doesas notshown includeby insulinunderline pumps.as follows:

Thus,§ this3560B. amendment exempts high deductible health plans if providing LC :

Coverage for insulin pumps.

(a) For purposes of this section, “insulin pump” means a small, portable medical device that is approved by the U.S.

Food and Drug Administration to provide continuous subcutaneous insulin infusion.

LC :

06/24/202104/14/2021 12:1509:26 PMAM coverage(b) underAll group and blanket health insurance policies, contracts, or certificates that are delivered, issued for delivery, renewed, extended, or modified in this ActState ifshall doingprovide socoverage wouldfor causea themedically plannecessary toinsulin failpump toat beno treatedcost asto a highcovered individual, including deductible healthpayments planand undercost-sharing §amounts 223(c)(2)charged ofonce thea Internaldeductible Revenueis Code.met.

Catastrophic(c) healthExcept insuranceas plansprovided areunder onlysubsection available(b) toof peoplethis undersection, agenothing 30in andthis aresection notprevents includedthe inoperation groupof healtha insurance.policy provision required by this section as a deductible, coinsurance, allowable charge limitation, coordination of benefits, or a provision restricting coverage to services by a licensed, certified, or carrier-approved provider or facility.

Catastrophic(d) plansThis havesection lowdoes monthlynot premiumsapply andto veryaccident-only, highspecified deductiblesdisease, becausehospital theindemnity, individualMedicare insuredsupplement, underlong- theterm plancare, mustdisability payincome, foror mostother routinelimited medicalbenefit expenses.health insurance policies.

While(e) catastrophicThis healthsection insuranceapplies plansto coverall somepolicies, preventivecontracts, care,or federalcertificates lawissued, limitsrenewed, themodified, preventivealtered, careamended, servicesor thatreissued canafter beDecember included31, in2021. these plans and currently excludes the coverage required under this Act.

LCSection :3.

Amend Chapter 52, Title 29 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

§ 5213.

Coverage for insulin pumps.

(a) For purposes of this section, “insulin pump” means a small, portable medical device that is approved by the U.S.

Food and Drug Administration to provide continuous subcutaneous insulin infusion.

(b) The plan shall provide coverage for a medically necessary insulin pump at no cost to a covered individual, including deductible payments and cost-sharing amounts charged once a deductible is met.

Section 4.

Amend Chapter 5, Title 31 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

§ 528.