Specifications include, but are not limited to: • Establish affordability standards, through promulgated regulations, for health insurance premiums based on recommendations from the Primary Care Reform Collaborative (see 16 Del.C. 9904A), using any of the following: o Trends, including any of the following: Historical rates of trend for existing products; National medical and health insurance trends; Regional medical and health insurance trends; and Inflation indices; o Price comparison to other market rates for similar products; o The ability of lower-income individuals to pay for health insurance; and o Effective strategies carriers can use to maintain close control over administrative costs and enhance the affordability of products. • Establish targets for carrier1 investment in primary care to support a robust system of primary care by January 1, 2025; • Collect data and develop reports regarding carrier investments in health care to monitor and evaluate all of the following: o The calculation of the amount of primary care spending in this State, including data from the Delaware Health Care Claims Database (see 16 Del.C. § 10311 et seq.); o Carrier compliance with reimbursement rates for primary care required under 18 Del. C. §§ 3342B and 3556A; and o Health-care spending data collected and reported through the State benchmarking process; • Annually evaluate primary care spending, with consideration of overall total health-care spending; • Make recommendations to the Insurance Commissioner and the Primary Care Reform Collaborative (see 16 Del.C. 9904A) about appropriate reimbursement rates for primary care; and • Develop and annually evaluate affordability standards, through an open and transparent process, in collaboration with the Primary Care Reform Collaborative.