Gic Private Insurance: What You Need To Know

The Group Insurance Commission (GIC) is a state agency in Massachusetts that offers health and life insurance coverage to state and municipal employees, retirees, and their dependents. GIC health insurance is available to those who are retired or eligible for retirement with twenty or more years of state service, or at age 55 or 60 with ten or more years of state service. GIC offers a range of health insurance plans, including non-Medicare and Medicare products, with different residency requirements, provider networks, and premium costs. Wellpoint, formerly known as UniCare Massachusetts, is the exclusive health plan provider for GIC members, offering tailored services and high customer satisfaction rates.

GIC health insurance at retirement

GIC, or Group Insurance Commission, is a government organization in Massachusetts that offers health insurance and other benefits to retirees. At retirement, you are eligible to continue your GIC health and life insurance coverage.

Eligibility for Retirement with GIC Health Insurance

You are eligible for retirement with GIC health insurance at any age with twenty or more years of state service, or at age 55 or 60 (depending on your hire date) with ten or more years of state service.

Enrolling in GIC Health Insurance at Retirement

If you are retiring from state employment from a GIC-eligible agency, you can continue, change, or enroll in health coverage with the GIC. Enrollment and changes must be received within 60 days of retirement. If you do not enroll within this time frame, you must wait until the next Annual Enrollment period or have a qualifying event, such as involuntary loss of coverage, marriage, or a spouse's open enrollment.

GIC Health Insurance Options at Retirement

If you are under 65, you will continue with the same health insurance plan. If you are over 65, your health insurance choices depend on where you live and whether you or your spouse are eligible for Medicare. If you are retired, state law requires that you enroll in Medicare Parts A and B. If you continue working after age 65, you and/or your spouse can enroll in Medicare Part A. When you retire, you and/or your spouse must enroll in Medicare Part B and join a Medicare plan sponsored by the GIC.

Paying for GIC Health Insurance at Retirement

If you decide to continue your health insurance after retirement, the premiums will be deducted from your monthly pension. During the period before you receive your first pension check, the GIC will bill you directly for the premiums.

Changing GIC Health Insurance Plans at Retirement

As a retiree, you may change health insurance only during the annual enrollment period in April or if you leave your health plan's service area. To make changes to your health insurance plan, you must complete and submit a GIC Insurance Enrollment/Change Form (Form 1) to the Group Insurance Commission (GIC). Annual enrollment changes are effective the following July 1.

GIC non-Medicare health insurance products

The Group Insurance Commission (GIC) offers a range of non-Medicare health insurance products to its members. These products provide comprehensive benefits, including prescription drug coverage, and are designed to meet the diverse needs of GIC members.

One such product is the AllWays Health Partners HMO plan, which offers a simple, two-tiered network of providers and lower premiums. Members can also benefit from rewards and savings opportunities, virtual urgent care services, and access to wellness tools and health coaching.

The Fallon Health Select Care HMO plan is another option, featuring a broad network of providers and hospitals in Massachusetts and southern New Hampshire. This plan includes fitness reimbursements, discounts for Weight Watchers, and the "Oh Baby!" program, which offers free car seats, breast pumps, and prenatal vitamins for expecting parents.

For those seeking more flexibility, the Harvard Pilgrim Independence Plan POS allows members to see any provider within the extensive Harvard Pilgrim network, although at a higher premium. This plan is available to GIC employees living in Massachusetts and other New England states.

Additionally, the Health New England HMO plan offers a range of covered services, including primary care, specialist, and outpatient visits, as well as inpatient hospital care and outpatient surgery.

Lastly, the UniCare State Indemnity Plan provides three coverage options: Basic, PLUS, and Community Choice. Basic offers worldwide coverage for office visits and hospital care, while PLUS provides comprehensive coverage when using PLUS providers in New England. Community Choice offers the lowest premiums for those seeking hospital services at Community Choice hospitals in Massachusetts.

GIC members can review these and other available plans to select the one that best meets their individual needs and preferences.

GIC Medicare health insurance products

GIC Medicare health plans are available to those aged 65 and over, with different options depending on the individual's location and whether they are eligible for Medicare. For example, if a GIC member is still working after age 65, they can enroll in Medicare Part A. When they retire, they must enroll in Medicare Part B and join a Medicare plan sponsored by the GIC.

GIC offers a range of Medicare health plans, including:

• Harvard Pilgrim Medicare Enhance
• Health New England Medicare Supplement Plus
• Tufts Medicare Preferred
• Wellpoint Medicare Extension

GIC's Medicare plans automatically include Medicare Part D coverage through CVS SilverScript, which is a federal prescription drug program.

GIC Medicare members should be aware of certain requirements and restrictions. For instance, if an individual does not enroll in Medicare Part B within the specified timeframe, they may become ineligible for health coverage through GIC and may have to pay federal government penalties. Additionally, enrolling in a non-GIC Medicare Part D plan that cancels GIC coverage may result in a Medicare Part D late enrollment penalty if the individual wishes to re-enroll in GIC Part D coverage later on.

It is important for GIC Medicare members to carefully review the available plans, understand their specific situation, and make timely decisions to ensure they have the appropriate health coverage in place.

GIC health insurance premiums

The Group Insurance Commission (GIC) offers health insurance coverage to retirees, with premiums deducted from monthly pensions. The GIC provides a range of health insurance plans with varying premiums, allowing individuals to choose the option that best suits their needs.

For example, the AllWays Health Partners plan offers lower premiums with extras like $25-$500 back through DoctorSmartSM Rewards, saving up to $1,200 in premiums and up to $2,200 with other benefits and perks. This plan also includes virtual urgent care for $15 and up to a $300 fitness benefit.

The Fallon Health Select Care HMO plan is another option, with a broad network including access to Boston Hospitals and providers throughout Massachusetts and southern New Hampshire. This plan offers a $100 individual/$100 family annual fitness reimbursement and a 20% discount for Weight Watchers online.

The Harvard Pilgrim Health Plan has a more extensive network, but members pay a higher premium. This plan is available to GIC employees living in Massachusetts and other New England states, offering the freedom to choose any PCP within the network.

The Health New England HMO plan has a primary care provider office visit fee of $20 per visit and a specialist physician office visit fee of $30 per visit (Tier 1) and $60 per visit (Tier 2).

The UniCare State Indemnity Plan is the highest premium choice, offering coverage for office visits and hospital care anywhere in the world.

GIC health insurance and Blue Cross

The Group Insurance Commission (GIC) is a state agency in Massachusetts that administers health benefits for state employees and retirees. GIC health insurance is available to eligible state employees and their families, offering various plans with different premiums, coverage levels, and provider networks.

GIC health insurance provides comprehensive benefits, including prescription drug coverage, fitness reimbursements, wellness programs, and mental health resources. Members can access a range of tools to improve their health and well-being, such as health coaching, online wellness tools, and employee assistance programs.

One notable aspect of GIC health insurance is its flexibility, allowing members to choose from a variety of plans to find one that best suits their needs. For example, the UniCare State Indemnity Plan offers worldwide coverage for office visits and hospital care, while the Health New England HMO plan provides a range of coverage levels for different types of care, including primary care, specialist visits, and hospital admissions.

In comparison, Blue Cross Blue Shield (BCBS) is the largest health insurer in Massachusetts, serving as a competitor to the GIC. BCBS offers health plans to municipal employees and retirees, emphasising choice and flexibility. They argue that their plans can provide greater savings than the GIC, as purchasing power is not the primary driver of cost reduction in health insurance. Instead, they attribute cost savings to factors such as benefit design, where employees may pay a higher share of premiums, copayments, or deductibles.

While the GIC aims to negotiate health benefits and utilise bulk-buying power, BCBS highlights that their plans cater to the specific needs of municipalities. For instance, the "Municipal Blue" product from BCBS may offer more cost-effective coverage for municipalities with employees who file fewer claims. Ultimately, both GIC and BCBS provide health insurance options, but with different structures and approaches, allowing individuals and municipalities to choose the plan that aligns best with their requirements and preferences.

Frequently asked questions