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Employment, eligibility, and GIC benefits

An overview of your eligibility for GIC coverage as a new hire, and under various employment scenarios. Revised July, 2019.

Table of Contents

Annual Enrollment

Annual enrollment occurs every spring for plan election, enrollments and changes effective on July 1. 

Dependent information

In order to enroll your eligible spouse, former spouse and/or dependents in GIC health insurance, you must complete the GIC Form 1 and provide a copy of a marriage certificate, birth certificate or hospital announcement letter (newborns only), separation agreement, divorce decree, certificate of appointment as legal guardian, etc., for each person you list as a dependent. If you are removing a spouse or dependent under age 19, you must do so during Annual Enrollment or within 60 days of a qualifying event. Under federal health care reform, Social Security Numbers must be provided for each spouse/dependent to be covered under the health plan. For a newborn only, the Social Security Number can be provided at a later date. Please indicate the exact date of birth for each dependent. To cover a dependent age 19 to 26, you must also provide a completed Dependent Age 19 to 26 Enrollment Change Form.

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 may be eligible 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.

If you are eligible for both active employee and dependent benefits, you must choose either employee or dependent benefits; you may not have benefits under both statuses. 

Leaves of absence (state employees only)

Employees on a leave of absence without pay are billed monthly and must remit payment to the GIC to maintain GIC insurance coverage. An employee can cancel some or all of their GIC coverage while on a leave of absence. However, when the employee returns to work after a leave of absence he/she is subject to Annual Enrollment (basic life and health insurance) and Evidence of Insurability requirements (LTD and Optional Life). Employee on FMLA or military leave only, may enroll in GIC health insurance upon return from leave. The status change form (Form 1A) must be received at the GIC within 60 days of the return to work.

Return from FMLA or military leave

If you voluntarily canceled GIC health insurance coverage at the beginning of your FMLA or military leave of absence, you can re-enroll in GIC basic life and health insurance coverage upon your return from leave. Optional Life and Long Term Disability are subject to evidence of insurability unless you are returning from a military leave. The enrollment form must be received at the GIC within 60 days of the return to work. Forms received after 60 days are returned and you may re-apply during Annual Enrollment.

Long term disability (state employees only)

New state employees can enroll within 10 days of hire in Long Term Disability. If you don't apply as a new hire, you can apply at any time, but are subject to evidence of insurability.

New hires

Completed forms and required documentation must be received by your GIC Coordinator no later than your 10th calendar day of regular, benefit eligible employment. If you miss the deadline, you must have a qualifying event or wait until the next Annual Enrollment period to enroll in GIC insurance benefits. Because GIC premiums are paid a month in advance, you are subject to a 60 day new hire waiting period before your coverage is effective. For example, if you were hired on June 10, your coverage will not begin until September 1. 

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.

If you are eligible for both active employee and dependent benefits, you must choose either employee or dependent benefits; you may not have benefits under both statuses. 

Optional life insurance (state employees only)

New state employees can enroll within 10 days of hire in Optional Life Insurance for a coverage amount of up to eight times your salary. If you don't apply as a new hire, you can apply at any time, but you must have basic life insurance and you are subject to evidence of insurability. If you select an amount of Optional Life Insurance that is a multiple of your salary of two to eight times, up to $1.5 million maximum, you will be enrolled in the Automatic Increase; your Optional Life Insurance coverage will increase automatically after an increase in your salary. If you elect to change from a fixed amount (where your coverage does not increase as your salary increases) to Automatic Increase, you will be subject to evidence of insurability.

Qualifying status changes for health and optional life insurance

Employees and retirees who have a qualified status change during the year can enroll in GIC health insurance or change from individual to family coverage or family to individual with proof of the family status change. Documentation of the event and the completed form must be received at the GIC within 60 days of the qualifying event. Forms and documentation received after 60 days are returned and you may re-apply during Annual Enrollment.

State employees only - Employees actively at work who have the following qualifying family status changes during the year may enroll in or increase optional life insurance coverage without evidence of insurability in an amount not to exceed four times the salary: marriage, birth/adoption, divorce and death of a spouse. Proof of the qualifying event and the completed form must be received by the GIC within 31 days of the qualifying event. You must already have basic life insurance for this option. Forms received after 31 days are subject to evidence of insurability.

Retirement

The GIC will bill state retirees monthly for GIC premiums until the premium can be deducted from the retiree pension (generally three months). You must pay your GIC premiums to maintain coverage. Municipal retirees contact your benefits office for information on premium payment and pension deductions. 

If you and/or your covered spouse are age 65 or over, and eligible for Medicare Part A for free, you (and your covered spouse, if applicable) must enroll in Medicare Parts A and B to continue coverage with the GIC. If one of you (or other family members) is under age 65, the non-Medicare member(s) will be covered under a non-Medicare plan until he/she becomes eligible for Medicare coverage. A Medicare plan election form will be mailed to eligible members.

If you (the retiree), your spouse or other covered dependent is younger than age 65, the person or people under age 65 will continue to be covered under a Non-Medicare plan until you and/or he/she becomes eligible for Medicare.

When enrolling in one of GIC’s Medicare Plans, you will be automatically enrolled in the GIC’s SilverScript Medicare Part D prescription drug plan. After your enrollment is processed by the GIC, you will receive a mailing from SilverScript with information about the plan and advising you that you have the choice to opt out of the prescription drug plan. The opt-out letter is required by Medicare, but we do not recommend that you do so because if you opt out of SilverScript, you will lose your GIC medical, prescription drug and behavioral health coverage.

State employees who are enrolled in GIC's optional life insurance plan and retiring should review the amount of your optional life insurance coverage and its cost to determine whether you want to keep it or reduce your amount of coverage. If you do not change your optional life insurance coverage amount, you will be responsible for the new higher monthly premiums.

If you reduce your coverage to a fixed amount, the amount must be equal to or less than one times the amount of your salary at retirement. Another option is to reduce the multiple times your salary at retirement to a lower multiple. For example, if you currently have 6 times salary, you can only reduce to 5, 4, 3, 2, or 1 times your salary.

If you are eligible for both active employee and retiree benefits, you must choose either employee or retiree benefits; you may not have benefits under both statuses. 

Deferred Retirement

To be eligible for this benefit you must be vested with your retirement system and retain your right to collect a pension from that retirement system. Any withdrawal of funds or subsequent determination of ineligibility for a pension allowance disqualifies you from GIC benefits.

Transfers and terminations

Because GIC premiums are paid a month in advance, coverage terminates at the end of the following month after you leave a state agency or GIC participating municipality (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 will not be subject to the 60-day waiting period. You must remain in the same health plan. For other GIC benefits, the same rule applies. If you are hired after the coverage end date, you are subject to the 60-day new hire waiting period.

Work hours and eligibility

State employees must work at least 18.75 hours in a 37.5-hour workweek or 20 hours in a 40-hour workweek and must contribute to your Employer’s public sector retirement system. For GIC purposes, OBRA is not such a retirement system. For additional eligibility details, refer to the GIC’s regulations.

If you previously worked less than the minimum required hours for GIC benefits (18.75 hours) and now work at least 18.75 hours; GIC health insurance benefits will begin on the first day of the month following 60 days or two full calendar months from the day you begin working the required hours for benefits.

Your GIC coverage will end on the last day of the month following the reduction of hours after your hours are reduced to less than 18 ¾ hours in a 37.5 hour work week or 20 hours in a 40-hour work week provided your premium for that month is paid. For example, if your hours are reduced on June 10, your coverage will end July 31. You may elect to continue coverage through the Health ConnectorGIC COBRA or non-group conversion through your health plan.

If you are eligible for both active employee and retiree benefits, you must choose either employee or retiree benefits; you may not have benefits under both statuses. 

Contact

Phone

Main Phone (617) 727-2310

M-F 8:45 a.m.-5 p.m.

TDD/TTY 711

Fax

Operations (617) 227-2681
Executive (617) 227-5181
Fiscal (617) 367-9874

Address

Street Address
John W. McCormack Building, 1 Ashburton Place
Suite 1619
Boston, MA 02108
Enrollment Form and Member Correspondence Mailing Address
PO Box 556
Randolph, MA 02368
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