All in a Day’s Work
Town of Saugus Joins the GIC

Town of Saugus employees, retirees and their dependents, pursuant to a legislative amendment to Chapter 67, joined the GIC for health coverage effective January 1, 2008.  With little lead time, GIC and town staff threw themselves into ensuring a smooth transition.  New communication materials, enrollment forms, and required documentation information were developed and mailed.  A nine-hour registration was held on a Saturday at a local elementary school to answer questions and enroll employees and retirees:

• GIC health plans staffed tables to answer health plan-specific questions
• The GIC held informational sessions throughout the day to give an overview of options
• GIC and Saugus staff assisted people in line to be sure that they had all of their documents, their questions were answered, and photocopies were made before entering the enrollment area
• Saugus staff color-coded applications to quickly designate which applications were for employees, retirees or GIC Retired Teachers converting to municipal coverage.
• Six enrollment stations were staffed by GIC employees.
• Saugus staff batched and photocopied forms and documents so that enrollments could be entered into the GIC’s eligibility system and the town’s payroll and pension systems in a timely manner

“Everyone pitched in to make this a success,” said Dolores L. Mitchell, the GIC’s Executive Director.  Nearly 900 Saugus enrollees joined the GIC, including over 200 GIC Retired Municipal Teachers who changed to the municipal program and are now eligible for all GIC health plans.  “Getting accurate eligibility files and collecting all of the necessary documentation is particularly time consuming and new municipalities joining July 1 will have the benefit of additional time to accomplish their transitions,” said Ms.  Mitchell.  “We can’t say enough about how helpful the Town of Saugus staff was to make this transition possible,” she said. 

State Employee and Retiree Benefit Statements
Mailed in Late January

Commonwealth of Massachusetts employees and retirees will be mailed a personalized annual benefit statement at the end of January.  This statement gives an overview of your benefits elections and who is covered under your policies.  Be sure to review the statement carefully to see if there are any errors.  Forms and instructions to make changes will be enclosed with the mailing.  If everything is correct, you do not need to do anything.  File your statement with your important papers; it’s the only statement you will receive in 2008.

Important Reminders:

• You MUST notify your GIC Coordinator (active employees) or the GIC (retirees and survivors) if you legally separate or divorce or if you or your former spouse remarries.  Failure to do so may result in financial liability to you.
• Active state employees – be sure to turn your statement over.  In cooperation with the State Board of Retirement, the GIC is again including your State Board of Retirement beneficiary information.  In the event that you die while still in active state service and before your retirement, this beneficiary (as distinguished from your GIC life insurance beneficiary) receives certain pension benefits as well as payment of any unused vacation and sick time owed. 
• Be sure to check the status of your 19 to 26 year old dependent.  Instructions for changing your dependent’s status will be enclosed inside the return GIC envelope.

SHPS DCAP ISSUE
SHPS has informed the GIC that they have been unable to load the HRCMS and UMASS payroll files of February 5, 2008 due to a systems problem. This is causing delays in DCAP reimbursements. The payroll files are being processed at SHPS.  Pending dependent care claims will be released on February 14, 2008 and deposits will show online within 48 hours.

How to Choose the Right Doctor

Choosing a doctor is one of the most important decisions you can make. You want to find a doctor with whom you feel comfortable, and who you think can give you the best medical care and advice.  Here are some steps to take when choosing a doctor:

Research the doctor’s background and training

• Contact your health plan to find out whether or not your doctor has the Tier 1 designation, which designates that he or she is a high-quality, cost efficient physician.  Physician tiering applies to all employee and retiree non-Medicare GIC plans.  You will save money with lower office visit co-pays when you see a Tier 1 physician. The most up to date physician tiering information is on each plan's website.
• Learn as much as you can about the doctor’s background and training. A good place to go for information is the Massachusetts Board of Registration in Medicine’s website.  Another source of information is WebMD’s physician directory , which  provides hospital affiliation and lists other physicians in a particular doctor’s practice.
• Check other quality and care reports.  An excellent source is the Massachusetts Health Quality Partners website . 

Make sure the doctor is right for you

• Find out how long it takes to get an appointment. Make sure the doctor can see you without a long delay.
• Find out how you can reach the doctor after hours if you have an emergency. Ask if the doctor sets aside time for patients in need of urgent care—or makes arrangements with other physicians to cover his patients to make sure you are seen when needed.
• Ask who will be part of your health care team. Find out what other medical staff are available to see you (such as physician assistants or nurse practitioners), if the doctor is not available.
• Ask if the office is open in the evening or on weekends. Longer office hours may be more convenient for you.
• Find out what happens when the doctor is on vacation. Ask if there are other doctors who can see you if your doctor is away.
• Check to see if the doctor’s office is easy to get to. Find out if you can take public transportation. If you drive, ask about parking.
• Ask if you can use e-mail to contact the doctor. This can be a quick and easy way for you to ask questions or share any concerns.

Call the doctors’ offices that you think would be a good fit, and say you are interested in an initial visit. Use this appointment to ask questions and find out how well the doctor listens and whether you feel at ease with him or her. Having a doctor you respect professionally and feel comfortable with personally is good for your health. So take the time to make the right choice.

Information on “How to Choose the Right Doctor” is culled in part from information provided by the Partnership for Healthcare Excellence, a statewide initiative dedicated to helping Massachusetts consumers improve the quality of their own health care.  The Group Insurance Commission is a member of the Partnership’s Leadership Council.  Check out the Partnership’s website for additional helpful tools, tips and resources for patients, including how to prepare for medical appointments, take medications safely, prepare for surgery, and find resources and tools from trusted sources.

Massachusetts GIC Enrollees
Look for New 1099-HC for State Tax Filing

GIC enrollees (Non-Medicare) who reside in Massachusetts were mailed a new form for state tax purposes.  The GIC’s health plans were mailed this form, called the 1099-HC, to their members at the end of January.  You will need this documentation as proof of health coverage for you and, if applicable, your GIC-covered spouse and dependents, for state tax purposes.

The Health Care Reform Act requires all Massachusetts residents to have health insurance by the end of 2007.  Those who do not will pay a penalty.  You or your tax preparer will use the 1099-HC form to complete the new Schedule HC form with your Massachusetts residential tax form.  Schedule HC is a new required tax return attachment for all Massachusetts residents.  After completion of your state taxes, retain this form with your tax information in case you get audited.

GIC members in one of our Medicare Plans (UniCare State Indemnity Plan Medicare Extension, Fallon Senior Plan, Harvard Pilgrim First Seniority Freedom, Health New England MedRate, Tufts Medicare Complement, Tufts Medicare Preferrred) will not receive a 1099-HC. According to the Department of Revenue, Medicare enrollees will fill out line 3C when they complete Schedule HC for your 2007 Massachusetts state taxes.

If you are a Massachusetts resident with Non-Medicare coverage and do not receive your 1099-HC, please contact your health plan.

History of The Clinical Performance Improvement Initiative and What It Means to You if You Are in a Non-Medicare Plan

Four years ago, the GIC began the Clinical Performance Improvement Initiative to improve health care quality while containing costs.  The GIC has quantified differences in physician cost-effectiveness and quality.  The GIC’s Employee and Non-Medicare health plans use this information to to develop benefit designs in which members are given modest co-pay incentives to use better performing providers that have a Tier 1 designation.  These plans are designated with the Select & Save logo.

Our Challenge

• Cost of employee health care in 2006 rose 7.7% nationally
• More than double the current inflation rate
• Exceeds the increase in the income of workers
• Since 2000, the cost of family coverage has risen 87% nationally

The GIC and our enrollees have done better than others, but escalating health care costs are a continuing challenge.  The GIC has a dual responsibility to our members and the Commonwealth’s taxpayers.

What Steps Have We Taken to Control Costs?

• Increase Premiums
  
• Increase Co-Pays
  
• Establish Disease Management Programs
  
• Tier Pharmaceuticals

What Have Other Employers Done?
Cut Benefits/Reduce Coverage
Eliminate Choice
Institute High Deductible Plans
Eliminate Retiree Benefits