Frequently Asked Questions
Health insurance coverage FAQ
On Feb. 28, the University announced that it will begin managing health insurance coverage for employees and retirees directly, effective July 1, 2025. Below, please review frequently asked questions about this decision. These FAQs will be updated regularly and as new information becomes available.
Health Transistion
The University of Delaware is separating from the State of Delaware’s Group Health Insurance Plan, starting July 1, 2025, to begin offering a self-funded healthcare plan for University faculty, staff and retirees.
Management of the following benefit plans will shift to the University of Delaware:
Medical insurance
Highmark First State Basic
Highmark Comprehensive PPO
Aetna CDH Gold
Aetna HMO
Highmark Special Medicfill (medicare supplement)
Prescription drug
CVS Caremark
Employee Assistance Program
Vendor TBD
Retiree Dental insurance
Vendor TBD
The University will begin managing its benefit plans on the following dates:
Active employees: The plan year begins July 1, 2025.
UD retiree Dental and pre-65 medical: The plan year begins July 1, 2025.
UD retiree Special Medicfill: The plan year begins Jan. 1, 2026.
The University of Delaware is committed to providing our employees and retirees with the best benefits package. In our current model of participating in the State of Delaware’s Group Health Insurance Plan, we do not have decision-making discretion and autonomy to tailor our coverage to the best meet the needs of our population. Further, the current University rates are decided based upon the claims that all State of Delaware participants incur, versus just University of Delaware participants, which can inflate premiums to cover the broad population of the state. Lastly, the University has been concerned about recent, significant and unexpected rate increases in the state’s system, which have been particularly stark in the last two years, and with greater increases anticipated over the next several years. Therefore, after careful consideration coupled with the feedback of many stakeholders, the University decided to move to a self-funded healthcare plan to secure discretion in decision-making to best meet the needs of our population, to align rate premiums with university employee experiences, and to obtain more control over cost management.
This decision was made with great care and consideration following a yearlong process led by UD Human Resources, accounting for the collective and individual perspectives of our employees and retirees, while also exploring alternative options and consulting with industry experts. The University engaged a benefits broker with extensive experience working with higher education institutions to conduct a four-year medical and prescription claims analysis, comparing the State of Delaware’s plan and a projected self-insured model. The University also conducted a benchmarking study, consulted the Benefits and Cost Containment Committee, and led a comprehensive request-for-proposals process to solicit vendors.
Yes. Management of our benefit plans will allow the University to:
Improve the healthcare and employee experience.
A self-funded plan provides better access to data, through which the University can gather detailed insights, help identify trends and cost drivers, and enable cost-containment strategies and better decision-making.
Provide more control over our plan’s design.
In this model, the University has decision-making discretion and autonomy to tailor its coverage options and benefits to best meet the needs of our population, providing better coverage and potentially reducing unnecessary expenses. The University also has the ability to negotiate networks through direct provider relationships that can improve costs and quality of services.
Support more-sustainably priced coverage.
The University has been concerned about recent, significant and unexpected rate increases in the state’s system, which have been particularly stark in the last two years, and with greater increases anticipated over the next several years. With a self-funded plan, the University can better project future budget impacts. Additionally, the University is only responsible for the claims that our participants incur, rather than inflated premiums to cover the broad population of the state.
Yes. President Assanis has appointed a University-wide Benefits Advisory Committee (BAC) that will consider and make recommendations on benefits provided to employees, such as healthcare. The membership of the BAC will consist of nine representatives from Human Resources (2), the American Association of University Professors (2), non-unionized staff (2), AFSCME unions (1 from each local) and the Fraternal Order of Police (1). BAC will be co-chaired by representatives from HR and AAUP-UD; members of the BAC will be selected or elected by their constituencies as they see fit. The BAC may make recommendations to the administration on any issue involving benefits.
Active Employees
- Those who are active and pension-eligible will transition out of the State’s GHIP to the University of Delaware plan 7/1/25; once they retire, they will return to the State’s pension GHIP benefits.
- Those who are active with the 403b as the primary retirement plan, will remain on university plans. Upon retirement, they will remain on University-managed benefits.
Retirees
- For retirees in the State Pension Plan:
- They are not impacted by these changes.
- Will remain on the State’s GHIP plans.
- For retirees in the University’s 403b retirement plan:
- Medicare-eligible retirees or dependents:
- Will transition out of the State’s GHIP dental plan on 7/1/25, and may elect dental coverage with the University’s plan.
- Will transition 1/1/26 to the University’s retiree Medicare supplement and prescription coverage by participating in October Medicare Open Enrollment.
- Non-Medicare eligible retirees or dependents:
- Will transition out of the State’s GHIP dental plan on 7/1/25, and may elect dental coverage with the University’s plan.
- Will transition 7/1/25 to the University’s retiree medical and prescription coverage by participating in May 1-16 Open Enrollment.
- Medicare-eligible retirees or dependents:
Double State Share refers to a benefit program that is available only to two individuals who are married before January 1, 2012, and are/were both employed (in a benefited-eligible position) or retired from their employment before January 1, 2012, with: the State of Delaware, the University of Delaware, Delaware Transit Corporation, Delaware Solid Waste Authority or Delaware State Housing Authority. Those who are eligible for the Double State Share benefit pay a different rate for participation in the State of Delaware Group Health Insurance Plan. The transition to the University’s self-funded health plan will not affect current participants in this program.
Annual Open Enrollment
Open enrollment for the 2025-26 plan year is from May 1–16, 2025.
- Eligible benefited employees: Yes, all benefits-eligible employees must log in to Flexnet and make an active election. If you do not make an election during this period, it could result in delays or a lapse of coverage.
- Retirees: The Open Enrollment communication will include detailed instructions on how to submit your enrollment.
All benefits-eligible employees will be required to make a benefits election during the open enrollment period. If you do not make an election during this period, it could result in delays or a lapse of coverage. The HR team will be diligently monitoring enrollment activity and following up with employees as needed to try and ensure that elections are made within the enrollment period.
Yes, a new member ID number and ID card will be issued. Employees will also have access to their member information through the health carrier's website.
No employee at the University will have access to individual claims data. No one at UD will be able to see individual claims data. The University of Delaware remains compliant with the federal Health Insurance Portability and Accountability Act (HIPAA).
We do not anticipate any gaps in coverage for employees who make benefits elections within the open enrollment period.
The University of Delaware will not make any medical or prescription vendor, plan design or employee contribution changes to our current offerings for active employees in FY26. If you switch benefits plans or change your coverage tier level, you may incur additional expenses depending on the costs associated with that plan.
The University of Delaware will not make any medical or prescription vendor, plan design or employee contribution changes to our current offerings for active employees in FY26. Therefore, if you choose to remain on the same plan for FY26, your coverage will remain the same. All benefits-eligible employees must log in to Flexnet and make an active election.
Your dependents may be covered under your health plan if they meet the eligibility requirements. Typically, eligible dependents include:
Spouse
Dependent Children
Disabled dependents
Yes, new hires are still eligible for benefits on the 1st of the month.
Yes. Current active, pension-eligible employees will move back to the State of Delaware’s Group Health Insurance Plan upon retirement.
Highmark, Aetna, and CVS Caremark will issue new cards to participants in the plan.
Retirees
Your enrollment in the Medicare Supplemental plan, Special Medicfill, will remain the same.
The University will provide its Qualified Faculty Retirees (defined as faculty who are currently retired, or those who will retire on or before December 31, 2025) and their spouses or surviving spouses, equivalent healthcare benefits to the Special Medicfill Medicare Supplement plan offered by the State of Delaware health plan as of December 31, 2025. Qualified Faculty Retirees will remain on original Medicare with a Medicare supplement plan equivalent to the state plan offered on December 31, 2025, including Part D prescription coverage, for their lifetimes.
Yes, the Open Enrollment communication will include detailed instructions.
Yes, the Open Enrollment communication will include detailed instructions.
The Medicare plan year is based on the calendar year, not fiscal year.
No, the current eligibility criteria are not impacted by this change.
No, your benefits will remain the same. However, if your retiree benefits are through the university, you will need to participate in May and October Open Enrollment. If your retirement benefits are through the Pension Office, your retiree benefits will remain the same.
Working Spouse Surcharge (WSS)
The Working Spouse Surcharge is an additional fee added to your medical plan premium if your spouse has access to medical coverage through their own employer but chooses to enroll in UD’s plan instead, or as primary coverage.
The surcharge helps manage healthcare costs by encouraging spouses who have access to their own employer-sponsored coverage to use it, helping the University control plan expenses and maintain more affordable premiums for employees.
The surcharge is $200 per month, added to your regular medical premium if applicable.
It may apply if:
- You cover a spouse under the University's medical plan AND
- Your spouse has access to group medical coverage through their employer.
Your spouse is exempt if:
- They work for the University of Delaware.
- They do not work.
- They are retired with primary retirement benefits through the University of Delaware.
- They are self-employed without access to group medical insurance.
- Their employer does not offer medical coverage.
- They are enrolled in Medicare or Medicaid, and their former employer contributes 50% or less of the retiree supplemental plan.
- They work part-time.
- Their employer does not contribute 50% or more of the lowest employee-only plan.
- They enroll under the University’s group medical insurance as secondary coverage.
You must complete a Working Spouse Verification Form during your benefits enrollment (initial and annual) or a qualifying life event. Failure to complete it may result in the automatic application of the surcharge.
Yes, the employee covering the spouse must complete the Working Spouse Surcharge Verification Form.
If your spouse gains or loses access to employer-sponsored medical coverage mid-year, you must report the change within 30 days to update your benefits and possibly adjust the surcharge.
If you do not certify your spouse’s work coverage status, the surcharge will apply automatically.
Yes, you may appeal if you believe the surcharge was applied in error by contacting the Human Resources, Benefits Department at hrhelp@udel.edu and providing supporting documentation within 30 days.
No, the surcharge applies only to the medical plan.
Yes, you may enroll your spouse. If your spouse is retiring from the University (excluding State Pension Retirees), you will need to complete the WSS Verification form, but the surcharge will not apply.
If your spouse is retiring from another employer, you must complete the WSS Verification Form. The surcharge will not apply if your spouse is not offered coverage or if they are required to pay more than 50% of the premium for the lowest-cost retiree-only plan.
If your spouse is retiring from another employer, you must complete the WSS Verification Form. The surcharge will apply if your spouse is offered coverage and the employer pays 50% or more of the medical premium of the lowest-cost retiree-only plan, but declines coverage.
No, you do not need to complete the "Spouse Employer Information" section. Please skip to Section IV: Acknowledgement.
Yes, if your spouse does not have access to medical coverage through their former employer. The surcharge will not apply.
Yes, if your spouse will have access to medical insurance but will be responsible for more than 50% of the lowest retiree-only plan. The surcharge will not apply.
Yes, if your spouse will have access to medical insurance but will not be responsible for more than 50% of the lowest retiree-only plan and declines coverage. The surcharge will apply.
Yes, if your spouse is enrolled in health insurance through their employer (current or former employer if retired) and is responsible for 50% or less of the premium for the lowest retiree-only plan, and you choose to enroll them under the University’s health plan as secondary coverage. The surcharge will not apply.
Yes, you must complete the WSS Verification form during Open Enrollment, May 1 - 16, 2025.
No, the WSS Verification form does not need to be completed at this time. A retiree and spouse currently enrolled in the Special Medicfill plans will remain under the State’s plan through 12/31/25, therefore, the WSS will not be applicable during this Open Enrollment event.
Yes, you may enroll your spouse; however, they should consider enrolling in their State Retiree medical plan.
If your spouse declines coverage through the State and is enrolled under the UD medical plan, the Working Spouse Surcharge Program will apply. In this case, the UD retiree will be responsible for a $200 monthly surcharge, in addition to the regular premium or Double State Share premium, if applicable.
For more information, please visit the Working Spouse Surcharge Program.
Yes, the University of Delaware will no longer be considered a participating group with the State as of July 1, 2025. As a result, the State’s Spousal Coordination of Benefits rules will apply. Because you have access to retiree medical coverage through the University, you will no longer be eligible for coverage through the Office of State Pensions.
During this Open Enrollment period, you are required to enroll in medical coverage through the University.
When you turn 65, you must enroll in Medicare Part B. At that time, you will become eligible to enroll in the Medicare Supplemental Plan, Special Medicfill.
Additional Questions
The UD Human Resources Benefits team is available to answer additional questions. Email HRhelp@udel.edu, complete this form or call (302) 831-2171 for support.
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