Title 18 — Insurance Code
83 chapters · 1,008 sections in this title.
18 Del. C. § 3801. Short title.
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§ 3801. Short title. This chapter shall be known and may be cited as the “Dental Plan Organization Act.”63 Del. Laws, c. 49, § 1;
18 Del. C. § 3802. Definitions.
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§ 3802. Definitions. Definitions as used in this chapter: (1) “Child with a severe disability” means a person under the age of 21 who, due to a significant mental or physical condition, illness, or disease, is likely to require specialized treatment or supports to secure effectiv…
18 Del. C. § 3803. Certificate of authority — Required; application procedure; filing fee.
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§ 3803. Certificate of authority — Required; application procedure; filing fee. (a) No person may establish, operate or administer a dental plan organization, or sell or offer to sell, or solicit offers to purchase, or receive advance or periodic consideration in conjunction with…
18 Del. C. § 3804. Certificate of authority — Conditions for issuance; disapproval; expiration; renewal.
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§ 3804. Certificate of authority — Conditions for issuance; disapproval; expiration; renewal. (a) The Commissioner shall issue a certificate of authority if the Commissioner is satisfied that the following conditions are met: (1) The persons responsible for conducting the affairs…
18 Del. C. § 3805. General surplus; special contingent surplus.
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§ 3805. General surplus; special contingent surplus. (a) The Commissioner may determine, at his or her discretion, the amount of a general surplus, if any, that the dental plan organization shall be required to maintain. (b) A dental plan organization utilizing in the aggregate t…
18 Del. C. § 3806. Bonding requirement.
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§ 3806. Bonding requirement. Any director, officer, employee or partner of a dental plan organization who receives, collects, reimburses or invests moneys in connection with the activities of the organization shall be bonded for his or her fidelity in an amount which shall be det…
18 Del. C. § 3807. Medical negligence insurance.
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§ 3807. Medical negligence insurance. Each dentist employed by a dental plan organization shall be insured against professional liability or medical negligence by an insurer licensed to conduct business in this State for such minimum amounts as shall be determined by the Commissi…
18 Del. C. § 3808. Evidence of coverage.
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§ 3808. Evidence of coverage. (a) An enrollee shall be entitled to receive evidence of coverage or a certificate indicating specifically the nature and extent of coverage, and evidence of the total amount or percentage of payment, if any, which the enrollee is obligated to pay fo…
18 Del. C. § 3809. Schedule of charges.
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§ 3809. Schedule of charges. (a) No schedule of charges for enrollee coverage for dental services, or amendment thereto, may be used by a dental plan organization until a copy of such schedule, or amendment thereto, has been filed with the Commissioner. The Commissioner may disap…
18 Del. C. § 3810. Examination of records.
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§ 3810. Examination of records. (a) The Commissioner or his or her designee may, as often as he or she may reasonably determine, investigate the business and examine the books, accounts, records and files of every dental plan organization. For that purpose the Commissioner or his…
18 Del. C. § 3811. Complaint system.
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§ 3811. Complaint system. (a) A dental plan organization shall establish and maintain a complaint system to provide reasonable procedures for the resolution of written complaints initiated by enrollees concerning dental plan services. The dental plan organization shall maintain r…
18 Del. C. § 3812. Annual report.
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§ 3812. Annual report. (a) Every dental plan organization annually on or before March 1 shall file with the Commissioner a report covering its activities for the preceding calendar year. (b) The reports shall be on forms prescribed by the Commissioner and shall include: (1) A fin…
18 Del. C. § 3813. Maximum portion of income used for expenses.
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§ 3813. Maximum portion of income used for expenses. A dental plan organization shall not use more than 30 percent of its gross contract and certificate income in the first year of operation, 25 percent in the second year of operation and 20 percent in any subsequent year for gen…
18 Del. C. § 3814. Advertising.
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§ 3814. Advertising. (a) No dental plan organization, or representative thereof, may cause or knowingly permit the use of advertising which is untrue or misleading, solicitation which is untrue or misleading, or any form of evidence of coverage which is deceptive. For purposes of…
18 Del. C. § 3815. Suspension or revocation of certificate of authority.
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§ 3815. Suspension or revocation of certificate of authority. (a) The Commissioner may suspend or revoke any certificate of authority issued to a dental plan organization pursuant to this chapter if he or she finds that any of the following conditions exists: (1) The dental plan …
18 Del. C. § 3816. Cease and desist order.
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§ 3816. Cease and desist order. (a) The Commissioner may issue an order directing a dental plan organization or a representative of a dental plan organization to cease and desist from engaging in any act or practice in violation of this chapter. (b) Within 20 days after service o…
18 Del. C. § 3817. Civil penalty; exceptions.
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§ 3817. Civil penalty; exceptions. Any dental plan organization which violates any provisions of this chapter, or neglects, fails or refuses to comply with any of the requirements of this chapter, except the failure to file an annual report and the failure to reply in writing to …
18 Del. C. § 3818. Injunctive power.
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§ 3818. Injunctive power. Whenever any dental plan organization shall become insolvent or shall suspend its ordinary business for want of funds to carry on the same, or whenever the Commissioner shall ascertain, as a result of examination as authorized by this chapter, or in any …
18 Del. C. § 3819. Confidentiality of documents.
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§ 3819. Confidentiality of documents. Applications, filings and reports required under this chapter, except contracts referred to in § 3803(c)(4) and (5) of this title, shall be treated as public documents and shall not be considered confidential.63 Del. Laws, c. 49, § 1; 80 Del.…
18 Del. C. § 3820. Confidentiality of data pertaining to diagnosis, treatment or health of enrollees.
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§ 3820. Confidentiality of data pertaining to diagnosis, treatment or health of enrollees. Data or information pertaining to the diagnosis, treatment or health of any enrollee obtained by the dental plan organization from the enrollee or any dentist shall be confidential and shal…
18 Del. C. § 3821. Exemptions from application of chapter.
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§ 3821. Exemptions from application of chapter. Except with respect to the dental plan organization activities of a duly organized and authorized insurer or medical or dental service corporation, which activities are authorized and regulated pursuant to this chapter, this chapter…
18 Del. C. § 3822. Rules and regulations.
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§ 3822. Rules and regulations. The Commissioner may promulgate such rules and regulations as he or she may deem necessary to effectuate the purposes of this chapter.63 Del. Laws, c. 49, § 1; 70 Del. Laws, c. 186, § 1;
18 Del. C. § 3823. Advisory Council.
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§ 3823. Advisory Council. Repealed by 77 Del. Laws, c. 106, § 2, effective July 6, 2009.