GIC Dental/Vision Plan for Managers, Legislators, Legislative Staff and Certain Executive Office Staff
ELIGIBILITY FOR THE GIC DENTAL AND VISION PLAN
The GIC Dental/Vision Plan is for state employees who are not covered by collective bargaining or do not have another Dental and/or Vision Plan through the state. The plan primarily covers managers, Legislators, Legislative staff, and certain Executive Office staff. Employees of authorities, municipalities, higher education, and the Judicial Trial Court system are not eligible for GIC Dental/Vision coverage.
During Annual Enrollment or within 60 days of a qualifying event, eligible employees may enroll in GIC Dental/Vision. During Annual Enrollment, current participants may change their dental plan selection.
The GIC has selected Metropolitan Life Insurance Company (MetLife) to continue as its carrier for the dental portion of the GIC Dental/Vision Plan.
There are two dental plan options:
- The PPO Plan (also known as the MetLife Value Plan), and
- The Indemnity Plan (also known as the MetLife Classic Plan).
Both plans include MetLife’s network of dentists and offer the following in-network benefits:
- 100% coverage for preventive and diagnostic services
- 80% coverage for basic services, such as root canals and extractions
- 50% coverage for major services, such as dental implants
Benefit Enhancements and Changes Effective July 1, 2017
- Rates are decreasing;
- Reimbursement for preventive and diagnostic services will not accumulate against the annual maximum benefit – your annual maximum will now be able to be used exclusively on more extensive services;
- Periodontal maintenance cleanings coverage will increase to 100%;
- The lifetime Orthodontic maximum will increase to $1,500;
- The annual per-person calendar year maximum will increase to $1,500 for in-network claims and $1,250 for out of network claims; and
- In keeping with industry standards, out of network claims will be reimbursed at the 90th percentile of Usual and Customary charges.
Weigh Your Dental Plan Options
With either dental plan, if you use MetLife's network of participating dentists, you will be able to take advantage of negotiated fees, even after you have exceeded your annual maximum.
The GIC recommends that you check to see whether you and/or your dependents receive all of your dental care from a participating MetLife dentist:
- PPO Plan (MetLife Value): If you and/or your dependents receive all of your care from a participating MetLife dentist, this plan will help you save on monthly premium costs and will also usually lower out-of-pocket costs. However, if you are in the PPO (MetLife Value) Plan and you go out of network, you will need to satisfy a $100 deductible and the benefit levels are slightly lower.
- Indemnity Plan (MetLife Classic): If you and/or your dependents intend to not visit participating dentists, choosing this plan will provide higher benefit levels, but at a higher monthly premium cost.
Keep in mind that once you choose a dental plan, you may not change plans until the next annual enrollment, even if your dentist leaves the plan during the year.
Contact Metlife for a list of participating dentists, frequency of covered services, and out-of-network benefits.
Davis Vision is the vision provider for the vision portion of the GIC Dental/Vision Plan. This plan provides a preferred provider network of almost 2,100 Massachusetts providers, with additional providers across the country. Members receive basic services every 24 months (age 19-60) or every 12 months (age 18 or under and 61 or over) at no cost:
- Routine eye examinations
- Fashion and designer frames
- Scratch-resistant lens coating
Premier collection frames are covered at any of the almost 700 nationwide Visionworks stores with no copay. Non-plan frames are covered up to $149.95 at Visionworks.
Enhanced materials and services at all preferred providers are covered at 100% after a copay. Members can also take advantage of Davis Vision discounts on additional eyewear. When members do not use a preferred provider, they are reimbursed according to a fixed schedule of benefits.
Vision Benefit Questions?
Contact Davis Vision for co-payment amounts, participating providers, and discount programs.
Davis Vision (client code 7852) 1-800-650-2466
This information provided by the Group Insurance Commission.