SB 316 — AN ACT TO AMEND TITLE 18 AND TITLE 29 OF THE DELAWARE CODE RELATING TO INSURANCE COVERAGE OF DIABETES EQUIPMENT AND SUPPLIES.

Pinkney DELAWARE& STATESen. SENATE 151st GENERAL ASSEMBLY SENATE AMENDMENT NO.

1Brown TO& SENATERep. BILL NO.

316Bentz AMEND& SenateRep. Bill No.

316Dorsey byWalker deleting& linesRep. 55 through 60 in their entirety and by inserting in lieu thereof:

“(b)Minor-Brown The& planRep. for regular employees and eligible pensioners who are not entitled to services, rights, or benefits under the federal Medicare program shall provide coverage for diabetes equipment or supplies as follows:

(1)S. A covered individual shall pay under the health plan no more than $35 per month for each enrolled individual, regardless of the amount or types of diabetes equipment or supplies needed.

Moore Sens.

Bonini, Ennis, Gay, Hansen, Hocker, Lawson, Lockman, Lopez, Mantzavinos, Paradee, Pettyjohn, Poore, Richardson, Sokola, Sturgeon, Townsend, Walsh, Wilson;

Reps.

Baumbach, K.

Johnson, Morrison, K.

Williams DELAWARE STATE SENATE 151st GENERAL ASSEMBLY SENATE BILL NO.

316 AN ACT TO AMEND TITLE 18 AND TITLE 29 OF THE DELAWARE CODE RELATING TO INSURANCE COVERAGE OF DIABETES EQUIPMENT AND SUPPLIES.

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

Section 1.

Amend Title 18 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

§ 3344D.

Cost sharing in diabetes equipment and supplies.

(a) For purposes of this section, “diabetes equipment and supplies” means blood glucose meters and strips, urine testing strips, syringes, continuous glucose monitors and supplies, and insulin pump supplies.

(b) An individual health insurance policy, contract, or certificate that is delivered, issued for delivery, renewed, extended, or modified in this State that provides coverage for any diabetes equipment or supplies must cap the total amount that a covered individual is required to pay for diabetes equipment and supplies at no more than $35 per month for each enrolled individual, regardless of the amount or types of diabetes equipment or supplies needed to fill the individual's prescriptions.

The $35 per month cap includes deductible payments and cost-sharing amounts charged once a deductible is met, except that the $35 cap does not apply to deductible payments charged by high deductible health plans or catastrophic health plans.

(c) Except as provided under subsection (b) of this section, nothing in this section prevents the operation of a 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.

(d) This section does not apply to any of the following:

(1) Accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care, disability income, or other limited benefit health insurance policies.

(2) A high deductible health plan if providing coverage under subsection (b) of this section would cause the plan to fail to be treated as a high deductible health plan under § 223(c)(2) of the Internal Revenue Code [26 U.S.C.

§ 223(c)(2)].

SD :

MD :

CBK Page 1 of 3 Released:

06/08/2022 04:25 PM (3) A catastrophic health plan if providing coverage under subsection (b) of 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.

§ 18022(e).

(e) This section applies to all policies, contracts, or certificates issued, renewed, modified, altered, amended, or reissued after December 31, 2023.

Section 2.

Amend Chapter 35, Title 18 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

§ 3560C.

Cost sharing in diabetes equipment and supplies.

(a) For purposes of this section, “diabetes equipment and supplies” means blood glucose meters and strips, urine testing strips, syringes, continuous glucose monitors and supplies, and insulin pump supplies.

(b) A health insurance policy, contract, or certificate that is delivered, issued for delivery, renewed, extended, or modified in this State that provides coverage for any diabetes equipment or supplies must cap the total amount that a covered individual is required to pay for diabetes equipment and supplies at no more than $35 per month for each enrolled individual, regardless of the amount or types of diabetes equipment or supplies needed to fill the individual's prescriptions.

The $35 per month cap includes deductible payments and cost-sharing amounts charged once a deductible is met, except that the $35 cap does not apply to deductible payments charged by high deductible health plans or catastrophic health plans.

(c) Except as provided under subsection (b) of this section, nothing in this section prevents the operation of a 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.