Updated on November 8, 2016
Q) Who is eligible for GIC benefits?
A) Generally, employees and retirees of the Commonwealth of Massachusetts and of certain other public entities, including most state authorities, local housing and redevelopment authorities, are eligible for GIC benefits if they participate in a public pension system and (for employees) work the requisite number of hours per week. Additionally, certain municipalities through the collective bargaining process, have elected to join the GIC’s health insurance benefits as a participating municipality. Certain municipalities also offer the GIC Retiree Dental Plan. Other municipalities have opted to insure their retired teachers through the GIC’s Retired Municipal Teacher program. For additional details, see the GIC’s regulatory definitions of Employee, Retiree, Dependent, and Regular Work Week. For further information, including a full list of entities with GIC health insurance, see the list of GIC Benefit Coordinators .
Q) As a new employee, when do my GIC benefits begin?
A) GIC health insurance benefits begin on the first day of the month following 60 days or two full calendar months of employment, whichever comes first.
For state employees, your basic life and health insurance benefits are on a pre-tax basis unless you opt out. GIC benefits for state employees can include: basic life, basic life and health insurance, long term disability, optional life insurance, dental/vision for employees not covered by collective bargaining, (primarily managers, Legislators, Legislative and certain Executive Office staff), and several GIC pre-tax programs: the Health Care Spending Account (HCSA) Program and the Dependent Care Assistance Program (DCAP). DCAP enrollment is effective as of your date of hire. Participating Municipal employees are eligible for health benefits only.
Q) I previously worked less than the minimum required hours for GIC benefits (18.75 hours) and was not eligible for GIC benefits. I am moving into a part-time (minimum 18.75 hours) or full-time position. When do my GIC benefits begin?
A) GIC health insurance benefits (state and municipal employees) begin on the first day of the month following 60 days or two full calendar months (whichever comes first) of the day you begin working the required hours for benefits. Most other state employee benefits (basic life, long term disability, optional life insurance, GIC dental/vision (if eligible) and the Health Care Spending have the same waiting period. Only the Dependent Care Assistance Program (DCAP) is effective as of your date of becoming eligible.
Q) I am leaving my current private sector job and will be eligible for GIC health insurance as a new hire in 60 days. What should I do about health insurance coverage during the 60-day waiting period?
A) The GIC recommends that you elect COBRA coverage through your former employer so that you have health insurance during the 60-day new hire waiting period. If you do not have COBRA coverage, you may be eligible to purchase health insurance through the Health Connector.
Q) During my GIC 60-day new hire waiting period, I (or my dependent) have had catastrophic medical expenses and do not have other health insurance or access to COBRA coverage through my former employer. Do I have any options to help cover these expenses?
A) If you or your dependent has an unplanned and urgent medical expense that exceeds the state’s or municipal’s full cost premium and this medical expense occurs on or after the first day of employment or waiting period but before the effective date of coverage, you can purchase coverage during your waiting period at the full cost premium. This option is sometimes called a B Waiver. Your coverage will be dependent on timely receipt of the full cost premium payment and approval from the health plan. Contact the GIC’s Public Information Unit at 617.727.2310 Ext. 1 for more information.
Q) Which state and participating municipal employees are eligible for GIC health insurance coverage?
A) To be eligible for GIC health insurance, a state employee or participating municipal employee must work a minimum of 18 ¾ hours in a 37.5 hour workweek or 20 hours in a 40 hour workweek. Employees working less than 18.75 hours per week are not eligible. The employee must contribute to a participating GIC retirement system, such as the State Board of Retirement, a municipal retirement board, the Teachers Retirement Board, the Optional Retirement Pension System for Higher Education, a Housing, Redevelopment Retirement Plan, or another Massachusetts public sector retirement system (OBRA is not such a public retirement system for this purpose). Temporary employees, substitute teachers, contractors, employees working less than 18.75 hours per week, and most seasonal employees are not eligible for GIC health insurance benefits. These employees may purchase health insurance through the Health Connector.
Q) I am an active state or participating municipal employee who works fewer than 18 ¾ hours per week in a 37.5 hour work week or 20 hours per week in a 40-hour work week; am I eligible for GIC benefits?
A) No. Non-GIC eligible employees can purchase health insurance through the Health Connector. See your GIC Coordinator and the Marketplace Notice for details.
Q) What happens to my GIC benefits if I work less than 18 ¾ hours in a 37.5 hour work week or 20 hours in a 40-hour work week?
A) Your GIC coverage will end at the end of the month after your hours are reduced provided your premium for that month is paid. You may elect to continue coverage through the Health Connector, GIC COBRA or non-group conversion through your health plan.
Q) I am an active GIC-eligible employee and also retired from a state agency/authority or participating municipality and eligible for GIC retirement benefits. Can I choose both employee and retiree benefits?
A) You must choose active employee or retiree benefits; you may not have benefits under both statuses. Contact the GIC 617.727.2310, Ext 2 to indicate whether you want employee or retiree benefits.
Q) I am an active GIC-eligible employee and also the dependent of a GIC-eligible state or participating municipal employee/retiree. Can I choose both employee and dependent benefits?
A) You must choose active employee or dependent benefits; you may not have benefits under both statuses.
Q) If I work for the state, participating GIC authority or municipality and transfer to another GIC agency or municipality, am I subject to the 60-day new hire waiting period?
A) Because your premiums are paid a month in advance, your coverage terminates at the end of the following month after you leave (for example, if you leave June 10, your coverage will end July 31). If you are hired by a state agency, authority, or participating municipality before the coverage end date, you are considered a transfer and your existing coverage will remain in force and you will not be subject to the 60-day waiting period. You must remain in the same health plan. If you were not enrolled in GIC health insurance at the time of this transfer you must wait until the next annual enrollment period to enroll.
State employees who were not enrolled in Long Term Disability or Optional Life may apply for these benefits subject to evidence of insurability. Or, if you were enrolled in these benefits they will continue. Note that if you are transferring to a participating municipality, you are only eligible to transfer your GIC health insurance benefits.
If you are hired by another agency/participating municipality after the coverage end date, you are not considered a transfer and are subject to the 60-day new hire waiting period.
Q) I was covered by a bargaining unit dental plan. Am I subject to a waiting period when I become a manager (subject to GIC Dental/Vision eligibility) and join the GIC Dental/Vision Plan?
A) If the GIC receives your completed Dental/Vision enrollment form within 60 days of the position change, the effective date will be the first day of the second month following the position change. If we do not receive the completed form within 60 days of the position change, you must wait until the GIC’s next Annual Enrollment period to enroll.
Q) I was just hired to work for the state and used to work for the state before. What premium contribution will I pay for basic life and health insurance?
A) If you were hired by the state before July 1, 2003, and have been rehired within two years of your termination date, you pay 20%. If you return to work with the state more than two years from the termination date, you pay 25%. For other scenarios, please visit the answers to common questions - employment status change section of our website. PREMIUM COST FOR NEW EMPLOYEES HIRED AFTER JUNE 30, 2003
Q) If my salary changes, does it affect my costs for any GIC benefits?
A) Premiums and benefits for optional life insurance and/or Long Term Disability coverage are based on salary and age. See the rate section for details.
Q) I work for an authority or state agency that is offering non-union Health Insurance, Long Term Disability or Life Insurance benefits through a non GIC vendor. Is this allowed?
A) No. All state agencies including housing and redevelopment agencies who provide GIC benefits to their employees cannot offer any benefits through non-GIC carriers if the GIC provides these benefits. Refer your agency’s legal counsel to Section 5.02 of the GIC regulations for additional details.
This information provided by the Group Insurance Commission .