State benefits committee OKs rate hike for retiree insurance 

Sam HautGovernment, Headlines


The SEBC voted on Tuesday to approve the rate increase for retirees on the Special Medicfill Plan.
Photo by Jonathan Borba, Unsplash.

The State Employee Benefits Committee unanimously approved raising the rate retirees pay for their Special Medicfill insurance plan. 

The committee in May voted to raise Medicfill rates by 5% starting Jan. 1, 2024, through June 30, 2024.

On Tuesday, though, the vote was to approve a specific dollar increase.

The increased rates will lead to no change for those who retired on or prior to July 1, 2012, as the state is paying for the entire plan of those members, costing the state $482.34 a month for the Special Medicfill plan with prescriptions and $273.46 a month for a Special Medicfill plan without a prescription.

For pensioners who retired after July 1, 2012, those with a prescription would have to pay an additional $24.10 a month on average and those without a prescription would have to pay an additional $13.66 a month on average.

Claire DeMatteis, secretary of the Department of Human Resources, said that 65% of the Medicare pensioner population won’t see an increase as they don’t pay anything for coverage because the state covers the cost for those retirees. 

The SEBC on Tuesday also discussed Highmark’s Custom Care Management Unit.

It is a program that helps people with chronic diseases manage those illnesses. In Delaware, members are slightly older and at a higher risk than national averages.

The average age for those in Delaware is 34.5, compared to the national average of 34.4.

Dr. Mark Jacobson, a medical director with Highmark, said that there’s about $850 per member per month in savings for people who use the case management program.

Related Story: State retirees on Medicare to pay 5% more for Medicfill plan

Those who use the Transitions of Care Program, another case management program for high risk, high cost admissions see a $964 per member per month decrease in costs, he said. 

Both of those numbers came from an internal report by Highmark which compared people who similar geography, socioeconomic status, gender, and age, and compared the costs of medical care for someone who was on the program and someone who wasn’t.

Those in the Custom Care Management Unit have more chronic conditions than the average, with 38.6% of those on the plan having two or more chronic conditions compared to Highmark’s average of 29%.

In the fourth quarter of 2022, 11 % of those insured by the state were in the Custom Care Management Unit. That’s up from 9.9% for the fourth quarter of the 2021 fiscal year, and up from the average of 4%.

The number of people in the Custom Care Management Unit that nurses were able to reach and talk to, called the engagement rate, was 88.6% for the fourth quarter of the 2022 fiscal year, compared to 83.9% the year before.

Jacobson said that percentage is higher than they expected. When Custom Care Management Units were first developed, they expected the percent engaged to be between 4% to 5%.

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