DE| Delaware’s revised Domestic and Foreign Insurers Bulletin No. 164 / Producer and Adjuster Bulletin No. 40, revised September 25, 2026, explains carrier and producer obligations under Senate Bill 71 and 18 Del. C. § 3411. The law gives Delaware-resident Medigap policyholders a birthday-related guaranteed-issue special enrollment period and creates protections for individuals moving from Medicare Advantage to Original Medicare. The rights attach to the individual—not the original policy or issuing state—so authorized Delaware carriers must comply for eligible Delaware residents, including residents whose Medigap coverage was issued elsewhere. Carriers must revise notices, underwriting, rating, marketing, training, and filing practices accordingly and maintain documentation for compliance review.
Key Points:
- Birthday Rule SEP: Eligible Delaware Medigap policyholders have a window beginning 30 days before their birthday and lasting at least 30 days afterward to switch to a Medigap policy with the same or lesser standardized benefits, with no medical underwriting; innovative or optional benefits do not affect the benefit comparison.
- Medicare Advantage transitions: People switching from Medicare Advantage to Original Medicare during the federal Annual Open Enrollment period or Medicare Advantage Open Enrollment period may buy any Medigap policy available in Delaware. Carriers cannot deny coverage, though they may medically underwrite, impose permissible pre-existing-condition limits, and charge appropriate premiums.
- Carrier compliance: Beginning January 1, 2026, authorized carriers must provide eligible policyholders notice 30–60 days before the birthday SEP, file proposed notices informally through SERFF, retain proof of distribution, use existing approved rates, avoid new substandard ratings, and ensure producer training and marketing materials accurately describe these rights.
Click here to see DE Revised Domestic and Foreign Insurers Bulletin No. 164 / Producer and Adjuster Bulletin No. 40