CHAPTER 319

AN ACT TO AMEND CHAPTER 51, TITLE 29, DELAWARE CODE, BY PROVIDING FOR THE COST OF THE PREMIUM OR SUBSCRIPTION CHARGES FOR A HEALTH CARE INSURANCE PLAN FOR REGULAR STATE EMPLOYEES AND ELIGIBLE PENSIONERS.

Be it enacted by the General Assembly of the State of Delaware:

Section 1. Chapter 51, Title 29, Delaware Code, is hereby amended by adding new sections thereto to read as follows:

§ 5120. Payment of premium or subscription charges for a Health Care Insurance Plan for State employees

(a) The State of Delaware shall pay the full cost of premium or subscription charges for a basic plan of health care insurance coverage for all regular officers and employees and for eligible pensioners of the State not otherwise covered under a group health care insurance contract.

(1) A "regular officer or employee" shall be one who has been continuously employed by the State of Delaware for the 12-month period immediately preceding the first day of any given month (exclusive of legal holidays and allowable leave) and who works the regularly scheduled full-time hours of the employing agency or at least thirty or more hours per week or 130 hours per month (with allowable interruptions) throughout the year.

(2) An "eligible pensioner" is one who is receiving or is eligible to receive retirement benefits in accordance with the State employees pension plan (Chapter 55, Title 29), the State Police pension plan (Chapter 83, Title II), or the pension plan for State Judiciary (Chapter 56, Title 29).

(b) If the employee or pensioner is covered in any way by a group insurance program issued by the same insurer, duplicate coverage shall not be procured by the state. However, it shall be at the employee's, or pensioner's, option as to whether to be covered by the state group insurance plan or by a program of the spouse. If covered by a program of the spouse, the employee or pensioner shall obtain no monetary credit or rebate from the state.

(c) For the purposes of this chapter, a husband and wife may each qualify as regular officer, employee, or eligible pensioner of the state. In the case where two members of a family qualify the following options are set forth:

(1) Each may elect to have insurance under the basic plan.

(2) The principal insuree may be the sponsor of the basic plan and the spouse may elect to procure "family, maternity or extended coverage" up to or equivalent to the cost of his or her basic coverage, the cost of which will be borne by the state. The increment of cost of the options selected by the spouse ("family, maternity or extended coverage") which exceed his or her basic equivalent shall be deducted by the State Treasurer from salary or pension.

(3) In no case shall there be a monetary credit or return to the spouse for his or her basic credits.

§ 5121. Specifications of the coverage.

(a) The basic Health Care Insurance Plan for State Employees shall be equivalent to the "Standard 80" hospital and surgical/medical plan currently offered by Blue Cross and Blue Shield of Delaware, Incorporated.

(b) The plan shall be for regular employees and eligible pensioners over sixty-five years of age who are not entitled to services, rights or benefits under the federal Medicare Program (U.S. Public Law 89-97, as amended); and "Delaware-65" hospital and surgical/medical plan for full-time employees and eligible pensioners entitled to services, rights or benefits under the federal Medicare Program.

(c) In accordance with the guidelines set forth in (a) and (b) of this section, the Insurance Commissioner, the State Treasurer, the Budget Director, and the Director of the State Personnel Commission shall review group insurance proposals of prospective carriers.

§ 5122. Selection of the group insurance carrier

(a) The health care insurance coverage shall be provided through a carrier incorporated under the laws of this State or legally authorized to transact business within this State, having adequate servicing facilities to carry out the terms of the contract

(b) The health care insurance coverage shall be provided by a carrier offering, at the employee's or pensioner's own expense, optional supplemental or extended benefits coverage to each regular employee or eligible pensioner and similar hospital, surgical/ medical and supplemental or extended coverage for such employee's or pensioner's spouse and dependents.

(c) The Insurance Commissioner, the State Treasurer, the Budget Director and the Director of the State Personnel Commission, after reviewing competitive group plans, shall select the carrier deemed to offer the best plan to satisfy the interest of the State, its employees and pensioners in carrying out the intent of this chapter.

§ 5123. Duties of State Insurance Commissioner

The State Insurance Commissioner shall be the agent of the State to enter into a contract with the carrier for group insurance for State employees and pensioners.

§ 5124. Duties of State Treasurer

The State Treasurer shall promptly notify the health care insurance carrier of the names and other necessary data related to the employees and pensioners covered and of all changes; and shall pay such obligations as are incurred pursuant to this section, including the cost of premium or subscription charges for health care insurance coverage upon the written request of any State employee, from the funds appropriated therefor, and, in the event such appropriated funds are inadequate, pay such additional sums as may be required from those moneys in the General Fund not otherwise appropriated; and upon written authorization shall withhold from the employee's salary or eligible pensioner's benefits such sums as are necessary for the payment of premium or subscription charges for the optional supplemental or extended benefits coverage and for spouse or dependent coverage.

Section 2. This Act shall become effective July 1, 1970.

Approved February 6, 1970.