Dominion National offers this marketplace health insurance plan (Plan ID 67775DE0020005) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.
Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Delaware). Submit changes before the deadline to avoid a coverage gap.
Enroll by Dec 15 for Jan 1 starts.
Finalize plan switches before the window closes.
Special Enrollment Periods
You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).
Report the event within 60 days.
Keep documentation handy for Healthcare.gov or your state exchange.
CSR & subsidy reminders
Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.
Enter accurate income to maximize Advanced Premium Tax Credits.
Standard Low Off Exchange Plan plans like this one keep deductibles and copays lower if you qualify.
Thinking about switching?
Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.
Match provider networks so ongoing care isn’t disrupted.
Confirm prescriptions stay on-formulary or budget for tier changes.
Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.
Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).
All providers in DelawareN/A
PCPs in DelawareN/A
Telehealth supportData pending
Nationwide providersN/A
N/A doctors statewideN/A PCPsN/A OB/GYN
Provider network(s)
['DEN002']
Providers
Delaware
All US states
All
N/A
N/A
PCP
N/A
N/A
Allergy
N/A
N/A
OB/GYN
N/A
N/A
Dentists
N/A
N/A
Drug coverage overview
0 drugs tracked
Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.
Prior authorization
Drugs
Required
0
Not Required
0
Step therapy
Drugs
Required
0
Not Required
0
Quantity limits
Drugs
Has Limit
0
No Limit
0
Customer highlights
What stands out for members
Issuer: Dominion National · Plan ID 67775DE0020005 · 2026 filing.
Issuer did not share extra notes for this benefit beyond the summary above.
Basic Dental Care - Adult
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Dental Check-Up for Children
10.00%
Tier 1 in-network10.00%
Out-of-network20.00%
Limit: 1.0 Visit(s) per 6 Months
Major Dental Care - Adult
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Orthodontia - Adult
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Orthodontia - Child
50.00%
Tier 1 in-network50.00%
Out-of-network100.00%
Covered Services, which are intended to treat a severe dental abnormality and are the only method capable of preventing irreversible damage to the Member's teeth or their supporting structures, and restoring the Member's oral structure to health and function.
Routine Dental Services (Adult)
Coverage details pending
Issuer did not share extra notes for this benefit beyond the summary above.
Variant attributes
Elite PPO Basic Kids · Variant 67775DE0020005-00
Plan identifiers & tier
Issuer-provided metadata for this variant.
Business Year
2026
CSR Variation Type
Standard Low Off Exchange Plan
HIOS Product ID
67775DE002
Metal Level
Low
Plan ID (Standard Component ID with Variant)
67775DE0020005-00
Plan Marketing Name
Elite PPO Basic Kids
Plan Variant Marketing Name
Elite PPO Basic Kids
Issuer & service area
Issuer-provided metadata for this variant.
Issuer ID
67775
Issuer Marketplace Marketing Name
Dominion National
Market Coverage
Individual
Multiple In Network Tiers
No
National Network
Yes
Network ID
DEN002
Out of Country Coverage
Yes
Out of Country Coverage Description
Standard Out of Network PPO Benefits
Out of Service Area Coverage
Yes
Out of Service Area Coverage Description
Standard Out of Network PPO Benefits
Service Area ID
DES002
State Code
DE
Cost sharing & actuarial values
Issuer-provided metadata for this variant.
Begin Primary Care Deductible Coinsurance After Number Of Copays
0
Inpatient Copayment Maximum Days
0
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out
Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group
$900 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person
$450 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual
$450
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group
per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person
per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual
Begin Primary Care Cost-Sharing After Number Of Visits
0
Child-Only Offering
Allows Child-Only
Composite Rating Offered
No
Dental Only Plan
Yes
EHB Apportionment for Pediatric Dental
1
First Tier Utilization
100%
Import Date
10/15/2025
Guaranteed Rate
Guaranteed Rate
New/Existing Plan
Existing
Medical EHB Deductible, Combined In/Out of Network, Family Per Group
$200 per group
Medical EHB Deductible, Combined In/Out of Network, Family Per Person
$100 per person
Medical EHB Deductible, Combined In/Out of Network, Individual
$100
Medical EHB Deductible, In Network (Tier 1), Family Per Group
$200 per group
Medical EHB Deductible, In Network (Tier 1), Family Per Person
$100 per person
Medical EHB Deductible, In Network (Tier 1), Individual
$100
Medical EHB Deductible, Out of Network, Family Per Group
$200 per group
Medical EHB Deductible, Out of Network, Family Per Person
$100 per person
Medical EHB Deductible, Out of Network, Individual
$100
Plan Effective Date
1/1/2026
Plan Expiration Date
12/31/2026
Plan Type
PPO
QHP/Non QHP
Both
Source Name
SERFF
Plan ID
67775DE0020005
Copay & coinsurance
Pharmacy cost sharing by tier
Drug tier
Pharmacy type
Copay amount
Copay option
Coinsurance rate
Coinsurance option
Mail order
Questions & answers
Frequently asked questions
How do I choose the right ACA plan in Delaware?
Elite PPO Basic Kids (67775DE0020005) is a Low PPO from Dominion National in Delaware for the 2026 coverage year.
Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.
Does Elite PPO Basic Kids support telehealth or virtual urgent care?
The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.
Is Elite PPO Basic Kids HSA-eligible and does it include dental or vision coverage?
HSA eligibility is not published; check the Summary of Benefits or ask the issuer.
Dental add-ons: Child.
Vision coverage is not listed for this plan.
Does Elite PPO Basic Kids support mail-order prescriptions?
Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.
Is there out-of-country coverage for Elite PPO Basic Kids?
Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: Standard Out of Network PPO Benefits
Does Elite PPO Basic Kids cover care outside the service area?
Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: Standard Out of Network PPO Benefits
How do I enroll in or manage payments for Elite PPO Basic Kids?
Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
