The state has not passed an protective DPC legislation, and we are not aware of any in the works. There are some DPC practices already operating in the state. When designing your contract be sure to review the Delaware Insurance Code. Some of the most important portions of the code are included below. For Delaware physicians, structuring the contract to avoid the definition of "insurance" might be easier than avoiding the label of a "discount medical plan."
TITLE 18 Insurance Code
CHAPTER 1. GENERAL DEFINITIONS AND PROVISIONS
§ 102 Definitions
(9) "Insurance" means a contract whereby one undertakes to pay or indemnify another as to loss from certain specified contingencies or perils, called "risks," or to pay or grant a specified amount or determinable benefit in connection with ascertainable risk contingencies or to act as surety.
§ 6403 Definitions.
"As used in this chapter, unless the context clearly indicates a different meaning, the following words and phrases shall have the meaning ascribed to them in this section:
(1) "Basic health services" means a range of services including at least the following: usual physician services, hospitalization, laboratory, x-ray, emergency and preventive services and out-of-area coverage.
(2) "Certified managed care organization" means a managed care organization which has been issued a certificate of authority under this title.
(3) "Department" means the Delaware Department of Insurance.
(4) "Health-care services" means any service included in the furnishing to any individual of medical or dental care, or hospitalization or incidental to the furnishing of such care or hospitalization, as well as the furnishing to any person of any and all other services for the purpose of preventing, alleviating, curing or healing human illness, injury or physical disability.
(5) "Managed care organization" means a public or private organization, organized under the laws of any state, which:
a. Makes health-care services, including at least the basic health services defined in paragraph (1) of this section above, available to enrolled participants;
b. Is primarily compensated (except for copayment) for the provision of basic health-care services to enrolled participants on a predetermined periodic rate basis; and
c. Provides physicians' services.
The organization may also arrange for health-care services on a prepayment or other financial basis."
One might argue that this managed care designation does not apply to DPC (even when prepaid) because under the required "basic health services" DPC does not provide coverage for emergency care or hospitalization services.
(4)a. "Discount medical plan" means a business arrangement or contract in which a person, in exchange for consideration paid by members, offers access for its members to providers of medical or ancillary services and the right to receive discounts on medical or ancillary services provided under the discount medical plan from those providers.
b. "Discount medical plan" does not include:
1. A plan that does not charge consideration from a member to use the plan's discount medical card; or
2. Any product already expressly authorized as insurance by the Commissioner pursuant to this title; or
3. Any physician or group of physicians or contracts regulated by the Board of Medical Licensure and Discipline.
(5) "Discount medical plan organization" means an entity that, in exchange for consideration, provides access for discount medical plan members to providers of medical or ancillary services and the right to receive medical or ancillary services from those providers at a discount. It is the organization that contracts with providers, provider networks or other discount medical plan organizations to offer access to medical or ancillary services at a discount and determines the charge to discount medical plan members.