DELAWARE INSURANCE DEPARTMENT

What If Your Plan Is Not Regulated By The State of Delaware?

Many large employers (more than 50 employees) in Delaware are self-funded. They do not buy health insurance from an insurance company but set employee premiums and company funds to pay health coverage claims submitted of their own employees.

The State of Delaware is not permitted to regulate these plans. They are authorized by Congress under terms of a law called ERISA (Employee Retirement Income Security Act) and are regulated by the federal government. What does this mean for you? It means that the Delaware General Assembly does not have the authority to require such plans to include specific benefits. And it means that the Delaware Insurance Department has no authority to investigate complaints that involve self-insured plans.

The designated regulatory authority is the US Department of Labor, Pension & Welfare Benefits Administration. If you have a problem with your self-insured employer, contact in this order:

The Plan Administrator

Your Employee Benefits Counselor at work

Your union representative

The U.S. Department of Labor, Pension & Welfare Benefits Administration

200 Constitution Avenue, N.W. Room N-5619 Washington, D.C. 20210 (202) 219-8776

Your Private Attorney