Revised on November 10, 2015
Is there anything Medicare-age retirees must do in order to join GIC health coverage?
Yes. If they are not already enrolled in Medicare, Medicare age retirees (65 years and older) must contact their local Social Security Office to determine if they are eligible to join Medicare. They may be eligible due to their own work history or through a spouse.
All retirees age 65 years and older who seek to join GIC health coverage must obtain a letter from the Social Security Administration stating whether they are or are not Medicare eligible, and they must give a copy of the letter to the Municipal Employer. If they are Medicare eligible but not enrolled, they must enroll in Medicare during the next federal government open enrollment period. They must enroll in Medicare before the following July 1 in order to have GIC coverage at that time. Medicare annual enrollment runs from January 1 to March 31 of each year.
We have not adopted the local option in Chapter 32B requiring all Medicare-eligible retirees to join Medicare. Do our Medicare-eligible subscribers need to enroll in Medicare before joining the GIC?
Yes. As of July 1, 2011, the question of whether to require Medicare-eligible retirees to join the GIC is no longer a matter of local option, but is generally mandated. An exception in c. 32B, § 18A for retirees with non-Medicare eligible family members does not apply to communities that have opted to transfer subscribers to the GIC. All retirees, spouses, and dependents insured or eligible to be insured under chapter 32B must enroll in Medicare Part B if they are eligible to enroll in Medicare Part A for free.
What other documents relevant to Medicare will over-65 retirees and spouses need to provide?
In the context of Section 19 and Section 23, immediately after providing notice of intention to join the GIC coverage, Municipal Employers must contact their retirees who are 65 years or older to inform them that:
- All retirees age 65 or older, except those already enrolled in Medicare, are required to contact the Social Security Administration to determine whether or not they are eligible for Medicare Part A for free;
- Retirees, spouses, and dependents must sign up for Medicare Part B if they are eligible for Part A for free in order to have GIC health coverage by the following July 1. Medicare-eligible enrollees and spouses must provide the GIC with:
- a photocopy of their Medicare card(s) for the enrollee, and for the spouse, if applicable)
- a photocopy of their latest 1099 or Benefit Verification letter from Social Security stating how the monthly Part B premium is paid (e.g. direct-billed or deducted), and the same for the spouse, if applicable;
- Retirees and spouses who are over age 65 and not eligible for Medicare must provide the GIC with a Social Security Denial letter stating that the enrollee or spouse is not eligible for Medicare Part A for free
The Federal Government’s open annual enrollment period for Medicare Part B begins January 1 and ends March 31 for health coverage effective July 1.
Who must pay the Medicare Part B premium penalty, if any, for persons enrolling in Medicare Part B?
By law, Municipal Employers must pay any Part B premium penalty assessed by the federal government on the retiree, spouse, or dependent as a result of enrollment in Medicare Part B at the time of transfer.
How will Municipal Employers obtain their Medicare Part D subsidy?
The GIC submits the subsidy information for its Medicare plans eligible for the subsidy. Following the subsidy reconciliation, the GIC will credit the municipality’s invoice on a proportional basis to the number of insureds the municipality has enrolled in these plans. The first credit is typically applied 18 months after the end of the fiscal year in which GIC coverage became effective.
This information provided by the Group Insurance Commission.