39-week Layoff Coverage - allows laid-off state insureds to continue their group health and life insurance for up to 39 weeks (about 9 months) by paying the full cost of the premium.

Case Management - a process that focuses on coordinating a number of services needed by patients with complex medical conditions. It includes an objective assessment of a patient's needs and develops an individualized care plan, within the scope of benefits, that is based on the needs assessment and is goal oriented. Patients' families may be involved as well. The goal is to provide the best possible management of care.

CIC (Catastrophic Illness Coverage) - an optional part of the UniCare State Indemnity Plan/ Basic . CIC increases the benefits for most covered services to 100%, subject to deductibles and co-payments. Enrollees without CIC receive only 80% coverage for some services and pay higher deductibles. Over 99% of current Basic and Medicare Extension Plan members select CIC.

COBRA (Consolidated Omnibus Budget Reconciliation Act) -a federal law that allows enrollees to continue their health coverage for a limited period of time after their group coverage ends as the result of certain employment or life events. Premiums cost 102% of the full cost group premium.

CPI (Clinical Performance Improvement) Initiative – a GIC program which seeks to improve health care quality while containing costs for the Commonwealth and our enrollees. Claims data from all six GIC health plans were aggregated to identify differences in physician quality and cost efficiency, and this information was given back to the plans to develop benefit designs. GIC members are subsequently rewarded with modest co-pay incentives when they use higher-performing providers. Plans that use cost efficiency and quality information to develop tiered networks are designated as Select & Save plans.

DCAP - (Dependent Care Assistance Program) - a pre-tax benefit that allows participants to set aside a certain amount of their income annually to use to pay certain employment-related dependent care expenses, such as child care or day camp, on a pre-tax basis. Open enrollment for this program takes place in the fall.

Deferred Retirement - allows you to continue your group health insurance after you leave state service until you begin to collect a pension. Until you receive a retirement allowance, you will be responsible for the entire life and health insurance premium costs, for which you are billed directly. If you withdraw your pension money, you are not eligible for GIC coverage.

EGR (Elderly Governmental Retiree) - a state employee who retired from state service prior to January 1, 1956. EGRs also include certain municipal employees who retired prior to the date their city or town elected to provide health insurance benefits to their employees/retirees and whose municipality has elected to participate in the EGR program.

GIC (Group Insurance Commission) - a quasi-independent state agency governed by a 13 member commission appointed by the Governor. The GIC provides and administers health insurance and other benefits for the Commonwealth's employees and retirees, and their dependents and survivors. The GIC also covers housing and redevelopment authority personnel, certain municipalities, and retired municipal teachers in particular cities and towns.

HCSA - (Health Care Spending Account) -a pre-tax benefit that allows employees to contribute a set amount of their income for non-covered health expenses, such as co-payments, deductibles, eyeglasses and orthodontia. Open enrollment for this program takes place in the fall.

HIPAA (The Health Insurance Portability and Accountability Act of 1996) - the Federal law protects employees' and their families' health insurance coverage when they change or lose their jobs. It also requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. The law also addresses the security and privacy of health data.

HMO (Health Maintenance Organization) -a health plan that provides coverage for treatment by a network of doctors, hospitals and other health care providers within a certain geographic area. HMOs do not offer out-of-network benefits.

Imputed Income – the value of any benefit or service that is considered income for the purposes of calculating federal taxes.  GIC benefits subject to imputed income include the value of health insurance coverage for same-sex spouses and for Non-IRS Dependents age 19 to 26.

IRS Dependent for GIC coverage  – usually a full-time student age 19 to 24, handicapped dependent age 19 to 26, or dependent age 19 to 26 who receives at least half of his/her support from the insured and who has a gross annual income of less than $3,200. IRS Publication 501 and the Dependent Age 19 and over section for details.

LTD - (Long Term Disability) - an income replacement program for active employees providing a tax-free benefit of up to 50% of salary if illness or injury renders them unable to work for longer than 90 days. Employees pay 100% of the premium.

Networks - groups of doctors, hospitals and other health care providers who contract with a benefit plan. If you are in a plan that offers network and non-network coverage, you will receive the maximum level of benefits when you are treated by network providers.

Non-Group Conversion - allows you to convert your life or health coverage from group to non-group status. You will be responsible for the entire premium. Call plans directly for details.

PCP (Primary Care Physician) - physicians with specialties in internal medicine, family practice, pediatrics, and sometimes OB/GYN.   Contact your plan for details.  For HMO members, you must select a PCP to coordinate your health care.

Portability - allows active employees who end employment with the Commonwealth to continue life insurance coverage at the same level of coverage. The premium for the portable life insurance coverage will be at the same rates you are insured for under the Commonwealth's group plan. Certain coverage and time limits apply.

PPO (Preferred Provider Organization)- a health insurance plan that offers coverage by network doctors, hospitals, and other health care providers, but also provides a lower level of benefits for treatment by out-of-network providers. A PPO plan does not require the selection of a Primary Care Physician.

RMT - a retired teacher from a city, town or school district who is receiving a pension from the Teacher's Retirement Board and whose municipality has elected to participate in the RMT program.