Group Insurance Commission

Administrative Bulletin FY13-01: Guidance Regarding Municipal Retiree Participation in the GIC Retiree Dental Plan

 

August 30, 2012

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In keeping with recent changes in the law, the Group Insurance Commission (GIC) will be expanding its Retiree Dental Plan to include certain municipal retirees and survivors – specifically, retirees, survivors, and their dependents of municipalities that offer health insurance to their active and retired employees through the GIC.  The purpose of this bulletin is to inform interested parties how the GIC will implement this expansion.

Background

The FY13 budget added parallel provisions to each of the two statutes that allow municipalities to offer health insurance via the GIC.  See M.G.L. c.32B, §§ 19(j) and 23(i), as amended by St. 2012, c. 139, §§ 66 and 67.  A municipality that has transferred its employees, retirees, survivors, and dependents to the GIC for the purposes of providing health insurance may also offer GIC dental insurance to their retirees and surviving spouses, plus their dependents.  Retirees and survivors of municipalities that administer health insurance other than through the GIC are not eligible for the GIC Retiree Dental Plan.  The new laws specify that participants must pay one hundred percent of premiums, plus an administrative fee of up to 1 percent.

In Order for Retirees to Participate, Municipalities Must Opt In

Municipalities will have an important role in the administration of the Retiree Dental Plan for municipal retirees.  Therefore, in order for a municipal retiree or survivor to enroll in the Retiree Dental Plan, the municipality must notify the GIC’s Executive Director of its intent to participate in the program.  Municipal retirees and survivors who wish to enroll in the Retiree Dental Plan should contact their municipality to express their interest in the program.

Participating Municipalities. Municipal Employers that currently offer health insurance through the GIC to their active and retired employees pursuant to a Public Employee Committee (PEC) agreement, a § 21 panel order, or special legislation (Springfield, Lawrence), or that will do so as of January 1, 2013 (Orange, Peabody), must notify the GIC’s Executive Director in writing by December 1, 2012 if they wish to offer the GIC’s Retiree Dental Plan as of July 1, 2013.  For Municipal Employers that do not opt in this year, these deadlines will repeat in future years (notice by a Municipal Employer by Dec. 1 for coverage the following July 1).  Participating municipalities who opt in to the Retiree Dental Plan must do so for the remaining duration of their PEC agreement or order. 

At the time that a currently participating Municipal Employer notifies the GIC that it will be extending its PEC agreement for another period of three or six years, the Municipal Employer should also inform the GIC in writing whether it intends to participate in the Retiree Dental Plan during that period.  If the Municipal Employer has opted into the GIC Retiree Dental Plan and is silent on the subject at the time of renewal, the Municipal Employer will remain in the Retiree Dental Plan for the duration of the new agreement.   

  • Example.  Town A is currently offering health insurance through the GIC, under the terms of a three-year PEC agreement that will expire on June 30, 2014.  They want to offer the GIC Retiree Dental Plan.  Town A’s Board of Selectmen should notify the GIC by Dec. 1, 2012 that they wish to opt in to the Retiree Dental Plan, effective July 1, 2013.  That election will remain in effect until June 30, 2014 (and may be extended under any future PEC agreement).

Prospective Municipalities (coverage effective July 1, 2013 or later).  At the time that a Municipal Employer notifies the GIC that it will be newly transferring its subscribers to the GIC pursuant to c. 32B, § 19 or 23, the Municipal Employer should also inform the GIC in writing whether it intends to opt into the Retiree Dental Plan for the duration of its PEC agreement or panel order.  The same deadlines apply as for health coverage (December 1 for July 1 coverage, and July 1 for January 1 coverage).  Municipal Employers that opt out at the first opportunity may still opt in at a later date, as described above for participating municipalities.

  • Example.  In November of 2013, Town B finalizes a § 19 Agreement with its PEC and notifies the GIC that it will be transferring its subscribers to the GIC for a three year period (July 1, 2014 – June 30, 2017).  Town B may opt into the Retiree Dental Plan as of July 1, 2014 by notifying the GIC by Dec. 1, 2013 (the § 19 deadline).  If Town B does not opt in as of Dec. 1, 2013, it has the same option the following Dec. 1. 

GIC RMT / EGR Municipalities.  Municipalities that participate and intend to remain in the GIC’s Retired Municipal Teacher (RMT) or Elderly Governmental Retiree (EGR) programs do not need to do anything.  The GIC’s RMTs and EGRs will continue to be eligible for the Retiree Dental Plan, and are unaffected by the change in law or this bulletin.

Enrollment

During the GIC’s regular Annual Enrollment each spring (usually mid-April to early May), retirees and survivors from municipalities that have opted into the Retiree Dental Plan may enroll in the Retiree Dental Plan for coverage effective July 1.  Except for new retirees and survivors, or with proof of involuntary loss of other non-GIC dental coverage, enrollment is only permitted during Annual Enrollment.  The GIC will work with municipalities to enroll new retirees and survivors as they become eligible.

An eligible retiree or survivor may enroll in the Retiree Dental Plan without also enrolling in a health plan.  However, dental-only coverage at the time of death will not qualify a retiree’s spouse to be eligible for subsequent GIC health coverage as a Surviving Spouse.

After July 1, 2013, former RMTs/EGRs in communities that have newly transferred all subscribers to the GIC per c. 32B, § 19 or 23, may remain enrolled in the GIC’s Retiree Dental Plan.  They will be treated as continuing and not new enrollees, and their benefit limits do not reset.

  • Example.  RMT X, from Town C, is enrolled in the GIC’s Retiree Dental Plan.  RMT X gets two cleanings, on Jan. 3, 2014 and June 25, 2014, thus reaching the limit of two cleanings per calendar year.  On July 1, 2014, Town C transfers all active and retired employees to the GIC, as authorized by a PEC agreement.  RMT X may remain in the GIC’s Retiree Dental Plan, but is not entitled to any more cleanings in 2014. 

Termination

Municipalities who have decided to offer the GIC’s Retiree Dental Plan may later opt out of the plan on the same schedule as they may opt out of health insurance: that is, by notifying the GIC’s Executive Director by October 1 of the final fiscal year of their PEC agreement or panel order. 

Eligible participants who voluntarily terminate their coverage in the Retiree Dental Plan may not later rejoin the plan, unless their termination was solely the result of their municipality’s decision to stop offering the GIC’s Retiree Dental Plan.

Cost

Premiums for the Retiree Dental Plan are established each year, effective July 1, by the Commission.  The Commission has the option of adding an administrative fee of up to 1% of premiums.  Retirees and survivors are responsible for the full cost of the premium and any administrative fee.

Allocation of Responsibilities

The GIC will develop communications materials as well as standard enrollment forms.  Municipal Employers will collect enrollment forms and supporting documents from eligible retirees and survivors.  The GIC makes the final determination of eligibility, all effective and termination dates, and all terms of the benefits offered through the Retiree Dental Plan.

A month in advance of each coverage month, Municipal Employers must collect premiums from enrolled participants.  The GIC will bill Municipal Employers monthly for the full cost of premiums plus the administrative fee, and payment must be received at the GIC by the invoice due date.  The GIC will send a monthly roster of enrollees  to Municipal Employers, who must reconcile the list of enrollees with their own records and report discrepancies to the GIC.

Exclusivity

Municipalities who opt into the Retiree Dental Plan must offer the GIC plan as their sole retiree dental coverage.


This information provided by the Group Insurance Commission.