State retirees’ health plan extended to June, 2024

Medicfill for Delaware’s retirees will remain in place until June 30, 2024, with rates to be determined in May, a key committee decided unanimously on Monday.

The special plan covers retired state employees. The state’s controversial idea to move them into Medicare Advantage was stopped by suit last fall from a group called Retirees Investing in Social Equity Delaware.

The Medicfill plan was set to end Dec. 31, 2023, but the State Employee Benefits Committee voted to extend it another six months because – as Claire DeMatteis, secretary of the Delaware Department of Human Resources, said – it still falls under the critical need statute.

“When we implement and enact this critical need exception, we need to show, by law, that the situation could not be reasonably seen or guarded against,” she said. “So as we sit here today, we can say that we reasonably can’t guard against the fact that we won’t have a Medicare or Medicare supplement or a Medicare Advantage or a combination of both in place for July 1.”

Paying for health benefits is a costly issue affecting a lot of people, which is why this meeting drew two of Delaware’s six officials elected nationwide and two members of the governor’s cabinet.

RELATED Retiree benefits subcommittee digs into Medicare concerns

The committee also voted to re-establish two subcommittees, one on finance and the other health policy and planning.

The full committee also made some changes about the subcommittees, including allowing for combined meetings between the two subcommittees, clarifying who can be appointed to the subcommittees, requiring meetings happen at least once per quarter, and removing a member requirement for the subcommittees.

Delaware Treasurer Colleen Davis said that she doesn’t feel that subcommittee members should be required to put themselves forward in roll call votes.

“I just feel it’s not really a fair thing to do to … members of my staff who are public servants, just like every state employee,” she said. “But hasn’t necessarily stepped forward to be in the public view in the way that an elected official or some cabinet secretaries have stepped forward to do. … I may just run out of staff that are willing to step forward.”

During the public comment section, Lynda Hastings said that she’s worried that June 2024 wouldn’t be in Medicare’s traditional open enrollment period.

Cerron Cade, director of the state Office of Management and Budget, said that the state can extend Medicfill rates again, that the extension is done to give the court case time to get resolved, and that they understand the concern about open enrollment period.

Insurance Commissioner Trinidad Navarro said earlier in the meeting that he’s heard concerns about the open enrollment period and that if retirees are taken off health insurance in June, they would have a special enrollment period.

Vote May 22 on Medicfill drug prices for retirees

The committee is scheduled to vote at its May 22 meeting on prescription drug prices for those on the Medicfill.

Prices at pharmacies are now $8 for generic drugs, $10 for brand formulary drugs and $50 for brand non-formulary drugs. All those prices are doubled for mail-order drugs. Specialty drugs have a copay based on their tier.

The first option would increase the cost of drugs purchased at the pharmacy to $10 for generic, $32 for brand formula, and $60 for brand non-formulary, with each cost doubled for mail-order drugs, and keeping the same price for specialty drugs. This option would save the state on the group health insurance plan $600,000.

The other three options would keep the original cost for drugs purchased at pharmacies and through the mail, but increase the cost of a 31-day supply of specialty drugs to a max of $50, $75 and $125, with those costs doubled for a 90-day supply.

These plans would save the state an estimated $1 million, $2.7 million and $3.4 million respectively. The first option would increase costs for everyone, and the fourth option would increase costs for the least number of people, 778.

An earlier version of this post incorrectly stated that pay rates would be frozen for the Medicfill plan and misstated what changes were voted on for the finance and health policy and planning subcommittees.