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Opinion: Good retiree healthcare coverage — a moving target

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Opinion: Good retiree healthcare coverage — a moving target


A response to Medicare or Medicare Advantage – CT employees want a choice by James W. Russell:

I agree with Russell’s frustration over the increasing privatization of Medicare. The health care eco-system, in Connectiut and nationally, is ever-changing and is now very different today than it was in 2018 when the State of Connecticut implemented a private, customized Medicare Employer Group Waiver (EGWP – pronounced “egg-whip”) plan for its’ retirees.

At that time, providers were generally accepting EGWP Medicare beneficiaries nationwide. Today, in-state and beyond, more providers are rejecting private Medicare, both EGWP plans and individual Medicare Advantage (MA) plans, for all the reasons Russell articulated – high claim denials, delayed payments, and crushing administrative requirements – plus, increasingly, extremely low provider reimbursement rates.

Unlike State of Connecticut retirees, Connecticut teacher retirees are not limited to one Medicare plan. Retired Connecticut teachers may choose between a customized EGWP plan (different from state retirees), or original Medicare with a supplement for out-of-pocket costs.

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Only about 10% of retired teachers choose the original Medicare/supplement option. Those who do are typically older individuals with higher health care resource needs who pay dearly for what they get from original Medicare – access to most providers nationwide and for their own treating provider (not an insurance company) to determine their medical needs and amount/length of services.

There’s no perfect solution, and there are unintended consequences for every health care decision balancing access to care, quality, and cost, but the conversation about how best to achieve that balance must be continuous for state retirees, retired teachers, and for one in five state residents insured by Medicare.

In the meantime, the best answer is to fight the fights you can win against private Medicare plans.

A 2018 report by the Centers for Medicare and Medicaid (CMS) Office of the Inspector General (OIG) found that less than one-percent of Medicare beneficiaries appeal a denial, but when they do, 75% of the time, that denial is over-turned on the first appeal.

Challenging insurance companies is critical, even if you do not have the time or energy to pursue a problem yourself. Connecticut has several free insurance assistance options for Medicare beneficiaries, in addition to professional help through the Comptroller’s Office (for state retirees) or the Teacher’s Retirement Board (for retired teachers).

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For further help with free insurance appeals, and other health insurance assistance, such as seeking exceptions to insurance company rules, contact the CT Office of the Healthcare Advocate (866) 466-4446, Healthcare.Advocate@ct.gov; or the private, non-profit law organization, the Center for Medicare Advocacy (860) 456-7790, Communications@medicareadvocacy.org.

Kathleen Holt is the Acting CT Healthcare Advocate. She is an appointed public member of the CT Teacher’s Retirement Board, Chairs the Board of Lawrence and Memorial Hospital, and was previously Associate Director of the Center for Medicare Advocacy.



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Connecticut

New businesses heading to West Haven’s shoreline

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New businesses heading to West Haven’s shoreline


New businesses are soon set to replace old, rundown buildings in West Haven.

By the end of the summer, the former Savin Rock conference center is slated to become the Kelsey, a restaurant and banquet facility.

Crews are currently working on the inside, according to Mayor Dorinda Borer.

Next door, Jimmies of Savin Rock sits empty after it closed last month. It was open for a hundred years and is now for sale.

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Borer said it’s another opportunity to draw people to the city.

“When there are new developers in town, and they’re making things all bright and shiny, that makes people attracted to our city,” Borer said. “It just seems like everything’s starting to bust loose at once. It’s a lot of work behind the scenes, and then it all starts to come to fruition.”

Thirty new luxury apartments are set to replace the Debonair Beach Motel that fell into disrepair after its last day open more than a decade ago. Demolition began last fall, and it’s expected to continue in March.

Down the street, new condos were built by the same owner of the restaurant and bar Riva. They opened their doors last summer, welcoming eager crowds.

“The turnout’s been unbelievable,” Riva’s owner, Michael Delvecchio, said. “People traveling from other states, New York, Rhode Island, all over Connecticut. It’s something that West Haven been dying for.”

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Riva replaced Chick’s Drive-In, a West Haven hot-dog and seafood staple that closed in 2015 after its owner passed away.

Delvecchio doesn’t ignore that history. A sign that says “The Lodge at Riva” will be removed and replaced with “Chick’s” during the summer, with accompanying pictures of Savin Rock amusement park on the walls.

“Everybody in town has been, with all this shoreline and all this beach, waiting for something to happen,” he said. “Riva’s a little bit of everything.”



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State opens investigation into former New Haven police chief amid stolen money allegations

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State opens investigation into former New Haven police chief amid stolen money allegations


Connecticut State Police and the Chief State’s Attorney have opened an investigation into former New Haven Police Chief Karl Jacobsen and allegations that he misused public funds.

The City of New Haven reported the allegations to State’s Attorney John Doyle on Monday.

New Haven Mayor Justin Elicker said Monday Jacobson admitted to stealing money from a fund used by the New Haven Police Department to pay for an support its confidential informant program.

Several officers flagged irregularities in the account and notified the three assistant chiefs in the department, according to Elicker. It was then that the assistant chiefs confronted Jacobson on Monday morning.

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Elicker said after being confronted, Jacobson admitted to taking the funds. The assistant chiefs then notified Chief Administrative Officer Justin McCarthy, who then notified Elicker.

Jacobson was called in for a meeting with Elicker, where he was to be placed on administrative leave. Elicker said that before the meeting, Jacobson handed in his paperwork to retire, effective immediately.

The mayor was unable to share additional details on how much money was reportedly taken or for how long due to the ongoing investigation.

Assistant Chief David Zannelli has been appointed as the acting police chief.

State police will conduct the investigation and Chief State’s Attorney Patrick Griffin has appointed New Britain Judicial District State’s Attorney Christian Watson to oversee the investigation to avoid any potential conflicts of interest.

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Made in Connecticut: Rochambeau Memorial Monument

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Made in Connecticut: Rochambeau Memorial Monument


This year, the U.S. celebrates the 250th anniversary of the signing of the Declaration of Independence. The French were instrumental in our fight for freedom, and their march through Connecticut is being memorialized in a new sculpture. News 12 met with the artist in this week’s Made in Connecticut.



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