State of Delaware Group Health Insurance Plan
Medicare Supplement - Highmark Delaware Special Medicfill

RATES EFFECTIVE JANUARY 1, 2027 TO DECEMBER 31, 2027

Retired Prior to or on July 1, 2012	Total Monthly Rate	State Share	Pensioner Pays
SPECIAL MEDICFILL with Prescription
Individual - 100% state share	$652.16	$652.16	$0.00
Individual - 75% state share	$652.16	$489.12	$163.04
Individual - 50% state share	$652.16	$326.08	$326.08
Individual - 0% state share	$652.16	$0.00	$652.16

Retired Prior to or on July 1, 2012	Total Monthly Rate	State Share	Pensioner Pays
SPECIAL MEDICFILL without Prescription
Individual - 100% state share	$369.74	$369.74	$0.00
Individual - 75% state share	$369.74	$277.31	$92.43
Individual - 50% state share	$369.74	$184.87	$184.87
Individual - 0% state share	$369.74	$0.00	$369.74

If you have less than 20 years of service and were first hired on or after July 1, 1991, the State does not pay the full state share but will pay a percentage of the state share of the cost of coverage as explained in the charts below.

Eligible Pensioners Hired By The State On Or After July 1, 1991 Through December 31, 2006
(The following portion of the State Share will be paid by the State)
(Except those receiving a disability pension or receiving an LTD benefit)

Less than 10 years service	0%	state share paid by state
10 years - less than 15 years service	50%	state share paid by state
15 years - less than 20 years service	75%	state share paid by state
20 years or more service	100%	state share paid by state

Eligible Pensioners Hired By The State On Or After January 1, 2007
(The following portion of the State Share will be paid by the State)
(Except those receiving a disability pension or receiving an LTD benefit)

Less than 15 years service	0%	state share paid by state
15 years - less than 17.5 years service	50%	state share paid by state
17.5 years - less than 20 years service	75%	state share paid by state
20 years or more service	100%	state share paid by state