Delaware pensioners get health care coverage extended following Medicare Advantage lawsuit

Bay to Bay News | by Joseph Edelen

The State Employee Benefits Committee approved a 12-month contract extension of the Special Medicfill Supplement plan during the committee’s monthly meeting on Monday.

The plan, which was set to be replaced by the state’s Medicare Advantage plan on Jan. 1, will be extended through Dec. 31, 2023 as a result of the committee’s vote. The extension allows the State Employee Benefits Committee to comply with Delaware Superior Court Judge Calvin L. Scott Jr.’s Oct. 19 ruling in which the implementation of the state’s Medicare Advantage plan was paused.

The State Employee Benefits Committee’s consulting firm, Willis Towers Watson, estimates the extension of the Special Medicfill Supplement plan will cost the state between $6.8 million to $7.5 million a month over the next year.

During that time, the State Employee Benefits Committee will consider several options, “which would include potentially renegotiating the existing contract or potentially rebidding the state pensioner health care plan,” according to Committee Co-Chair and Department of Human Resources Sec. Claire DeMatteis.

After approving the contract extension, the Committee voted to keep the current plan’s monthly rates; pensioners who retired on or prior to July 1, 2012 will continue to pay nothing, while pensioners who retired after that date will pay a monthly rate of $22.96 with prescription and $13 without.

The state’s monthly share of providing pensioners health care will continue to be $459.38 per pensioner with prescription. The Medicare Advantage Plan would have cost the state $216.18 for those who retired on or before July 1, 2012, and $205.38 for those who retired after.

Ms. DeMatteis said an estimated 2,500 and 3,000 state retirees who opted into the state’s Medicare Advantage plan will no longer receive a decrease in their monthly premium. Under the state’s Medicare Advantage plan, pensioners who retired after July 1, 2012 would have had a $10.80 monthly payment, while those who retired before would have none.

The Statewide Benefits Office, led by director Faith Rentz, will be responsible for outreach to pensioners notifying them of the change. In addition, the Office will reach out to the nearly 3,000 state retirees signed up for Medicare Advantage regarding their options following Monday’s decision.

Several state retirees participated in the public comment portion of the meeting, and while many thanked the committee for extending their current coverage, many admonished the committee for making the change in the first place. This included Retirees Investing in Social Equity (RISE) Delaware co-founders retiring Rep. John Kowalko, New Castle County Councilperson Lisa Diller, and Karen Peterson; the trio were plaintiffs in the lawsuit that paused implementation of the state’s Medicare Advantage plan.

With the State Employee Benefits Committee’s extension of the Special Medicfill Supplement plan, Delaware’s General Assembly will no longer reconvene on Oct. 26 for their special session. The House and Senate were scheduled to consider legislation that would provide oversight to the state’s Medicare Advantage plan.

With the cancellation of the special session, Rep. Kowalko will no longer have the opportunity to introduce legislation that would extend the Special Medicfill Supplement plan for three years. The bill could not be pre-filed, so it had to be introduced on the House floor and would have required a motion to suspend House rules. The bill had support from at least 17 legislators as of Monday morning.

Though the oversight legislation will no longer be considered, the Senate will still meet for a special session to confirm nominees from the Carney Administration.

In a joint statement, Senate President Pro Tempore Dave Sokola, D-Newark, and Speaker of the House Pete Schwartzkopf, D-Rehoboth Beach, expressed the legislature’s commitment to providing state retirees with the health care they earned.

“With the SEBC’s action to preserve the current retiree health plan in accordance with last week’s court order, there is no longer a need for the General Assembly to meet and consider legislation on this matter. While this is a victory for the many state retirees who expressed legitimate concerns about the switch to Medicare Advantage, we must continue to work to ensure they receive the healthcare they earned through their service to the state of Delaware,” Sen. Sokola and Rep. Schwartzkopf said.

The State Employee Benefits Committee’s next meeting will be held in a hybrid format on Nov. 21 at 2 p.m. The in-person meeting will be held at the Statewide Benefits Office in Dover, while a livestream can be found at

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