The Impact of SEBC’s Decisions on State Employee Health Plans: An Analysis

Health premiums for Delaware state employees set to increase

The SEBC recently decided not to vote on continuing enhanced COVID-19 benefits, which means employees will now have to pay pre-COVID-19 costs for services like primary care visits, hospital stays, and telemedicine. In a related decision, the state employee benefits committee awarded the operation of the Medicare Supplement Plan for retirees to Highmark Delaware for a two-year term starting January 1, 2025, with an optional one-year extension. This decision follows a lawsuit by retirees who opposed a previous attempt by the committee to move retirees to a Medicare Advantage Plan through Highmark, which was successfully blocked by the advocacy group RiseDelaware.

Shaun O’Brien, policy director with the American Federation of State, County, and Municipal Employees, voted against the decision citing concerns about the reliability of the SEBC and lack of transparency. State Rep. Paul Baumbach supported the decision virtually and expressed concerns about the lack of confidence in the committee’s actions while emphasizing the importance of keeping promises made to retirees regarding their healthcare benefits. Baumbach is sponsoring legislation to increase transparency and accountability within the committee.

The SEBC also approved changes aimed at ensuring equal access to care for individuals with mental health or substance abuse disorders and wigs and mastectomy bras as enhanced women’s benefits but did not approve cooling caps. The total cost of these changes to employee health plans was estimated at between $507,000 and $557,000 further highlighting its importance for state employees and retirees.

In addition to these decisions made by SEBC regarding employee health plans it is important that we consider how such changes impact those affected by them. The reintroduction of pre-COVID-19 costs may create financial strain for some employees who were able to access healthcare services without cost during the pandemic. Similarly, changes in insurance coverage may limit access to certain treatments or services that were previously available under enhanced plans.

Therefore it is crucial that there is increased transparency and accountability within SEBC when making decisions regarding employee health plans. It is vital that any changes made are communicated clearly so that employees can make informed decisions about their healthcare options.

Overall these decisions made by SEBC have significant implications on state employees’ lives and should be carefully considered before being implemented.

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