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The Process of Joining Municipal Health Insurance with the GIC

General procedure for transferring subscribers, Section 19 Agreements, Section 23 Agreements and Panel Process, Notice of Intent, and Withdrawal information.

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General Procedure for Transferring Subscribers to GIC Health Insurance

The sections of the General Laws that must be adopted by a Municipal Employer in order to join the GIC’s health coverage

Municipal Employers may formally adopt Chapter 32B, Section 19  in order to join the GIC’s health coverage through the Section 19 process.  Alternately, they may formally adopt Chapter 32B, Section 21 to join the GIC via Chapter 32B, Section 23 (or to implement plan design changes via Chapter 32B, Section 22).

VIA SECTION 19 (union)

Unionized Municipal Employers decide with their unions and retirees, negotiating together as a Public Employee Committee (PEC), whether to join GIC health coverage. The parties draft a written agreement to join GIC health coverage and send it to the GIC as their notice of intent to join GIC coverage. Receipt of the agreement will start the process for the Municipal Employer’s transfer to GIC health coverage. Agreements must be received by the GIC by December 1 of any year to begin work to transfer municipal subscribers to GIC health coverage beginning the following July 1, or by July 1 for coverage beginning the following January 1.

For more details about the coalition bargaining process and a model agreement, contact the Metropolitan Area Planning Council at 617/933-0700 or go to their “Health Insurance Action Center” .

VIA SECTION 23 (union)

Unionized Municipal Employers follow a similar procedure to join the GIC via Section 23 as via Section 19, but with two major differences: 

  1. The negotiation phase is limited to 30 days from the date the Public Employee Committee receives formal notice of a proposal from the Municipal Employer; and
  2. After that 30-day period, if no agreement has been reached, the proposal goes to a municipal health insurance review panel.  This panel must order the transfer of enrollees to the GIC if, as measured by guidelines in the statute, the panel finds savings from the transfer to GIC would meet or exceed the savings test in the statute 23, and would sufficiently mitigate the impact on those negatively affected by the transfer.

In either event (negotiated agreement or panel-ordered transfer), for transfer to be effective, the GIC must receive notice and the Municipal Employers’ full data census (requirements posted on the GIC’s website) by December 1 of any year in order to transfer municipal subscribers to GIC health coverage the following July 1, or by July 1 for coverage beginning the following January 1. (See below for further details on the municipal health insurance review panel process.) 

VIA SECTION 19 OR 23 (Non-union)

Non-union Municipal Employers decide as follows: a non-union city, town or district’s Chief Executive Officer decides whether to join GIC coverage; Non-union Municipal Employers must send a letter to the GIC as its notice of intent to join the GIC coverage and the Municipal Employers’ full data census (requirements posted on the GIC’s website) by December 1 (for July 1 coverage) or July 1 (for January 1 coverage) of any year.

Composition of the Public Employee Committee (PEC)

The Public Employee Committee includes a representative of each collective bargaining unit, and a retiree representative designated by the Retired State, County and Municipal Employees Association.  The retiree representative will have a 10% vote.  The remaining 90% vote is divided proportionally among the bargaining units according to the number of employees in each.

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How the employer determines whether to join GIC coverage, if only some of a Municipal Employer’s employees are unionized

The unions’ vote determines whether all of the Municipal Employer’s eligible subscribers join GIC health coverage via Section 19 or Section 23.

Dates for notice and commencement of coverage

As the result of a change in the law in June, 2012, notice and transfer dates were made uniform under Section 19 and Section 23 as follows:  a Municipal Employer must notify the GIC by December 1 of its intent to transfer municipal subscribers as of the following July 1, or by July 1 of its intent to transfer municipal subscribers as of the following January 1.

Section 19 Agreements for Municipal Health Insurance

(Unionized Municipal Employers)

What must be in a Section 19 bargained agreement to join GIC health coverage

Three issues: (1) whether to join GIC health coverage; (2) the health premium contribution ratios for the Municipal Employer’s subscribers, which can differ only by type of plan (PPO, POS, HMO or Indemnity) and not by type of subscriber (active, retired or survivor); and (3) the terms for revocation of Section 19 if the Municipal Employer or its subscribers wish to withdraw. There is an initial 3 year term when joining the GIC and withdrawal may only happen at whole-year intervals. The agreement must state a withdrawal interval, which must be at least 2 years. For more info. on withdrawing please see FAQs.  

You may not bargain benefits and carriers

No. For Municipal Employers joining GIC health coverage, the law suspends all collective bargaining related to municipal subscribers’ health insurance except their GIC health premium contribution ratios. The GIC has exclusive authority to determine all other matters relating to municipal subscribers’ GIC health insurance rights, responsibilities, cost, and payment obligations, including the manner and method of payment, eligibility requirements, choice of benefits, and health carriers.

You may negotiate to give subscribers incentives to join GIC health coverage

Yes.  When first enacted, municipal health reform limited what incentives Municipal Employers could offer to build support among employees.  However, statutory changes have largely eliminated these constraints.  Municipal Employers are urged to contact the GIC with questions about possible incentives before they execute PEC agreements.

Section 23 Agreements and Panel Process for Municipal Health Insurance

(Unionized Municipal Employers)

How to start the process of transferring subscribers via Section 23 for Municipal Employers

A Municipal Employer may commence the Section 21/23 process by notifying each of its collective bargaining units and the Retired State, County & Municipal Employees Association at least 7 days in advance of its intent to vote to implement the process, and by subsequently notifying them of the results of that vote.  For further information on required notifications and processes in this period, see the Administration and Finance regulations posted (See Additional Resources).

What needs to be in a bargained Section 23 Agreement

A Section 23 Agreement must include contribution ratios and the signatures of representatives of the Municipal Employer as well as a majority of the Public Employee Committee.

What happens if negotiations to transfer subscribers under Section 23 are unsuccessful

After a 30 day negotiation period, if no agreement results, a Municipal Employer may submit its proposal to a municipal health insurance review panel made up of a municipal representative, a representative of the Public Employee Committee, and a third impartial member identified with the assistance of Administration and Finance.  If the panel finds that the proposal meets statutory and regulatory guidelines around savings and mitigation, the panel may order the transfer of subscribers to the GIC under Section 23.  

Additional Resources

Notice Of Intent for Municipal Health Insurance

The documents a Municipal Employer must file with the GIC under Section 19 as its notice of intent to join GIC health coverage

Unionized Municipal Employers must provide two documents to the GIC: (1) a copy of the executed bargaining agreement to join GIC health coverage; and (2) a cover letter from an authorized official of the Municipal Employer confirming the Municipal Employer’s intent to join GIC health coverage.  Simultaneously, the GIC must receive the Municipal Employers’ full data census .

Non-union Municipal Employers must send a letter from their Chief Executive Officer stating their decision to transfer the Municipal Employer’s subscribers to GIC coverage. Simultaneously, the GIC must receive the Municipal Employers’ full data census.

All notices of intent under Section 19 must be filed by December 1 of any year for coverage to begin the following July 1, or July 1 for coverage to begin the following January 1.

The documents a Municipal Employer must file with the GIC under Section 21/23 as its notice of intent to join GIC health coverage

Unionized Municipal Employers must provide two documents to the GIC:

  1. EITHER: (a) a copy of the executed bargaining agreement to join GIC health coverage; OR (b) an order from a municipal health insurance review panel regarding transfer to GIC health coverage; and
  2. A cover letter from an authorized official of the Municipal Employer confirming the Municipal Employer’s intent to join GIC health coverage.

Non-union Municipal Employers must send a letter from their Chief Executive Officer stating their decision to transfer the Municipal Employer’s subscribers to GIC coverage.

All notices of intent under Sections 21/23 must be filed by December 1 of any year for coverage to begin the following July 1, or by July 1 for coverage to begin the following January 1.

Simultaneously, the GIC must receive the Municipal Employers’ full data census.

Why Municipal Employers must give notice of intent so far in advance

The law provides for advance notice by Municipal Employers because the GIC and their health carriers need to know the size of the pool with enough time to accurately price their proposed rates.  The rate renewal process begins in November of each year for coverage the following July. There is a great deal of work required by both the Municipal Employer and the GIC to transfer subscribers to GIC coverage regardless of the number of subscribers to be transferred.  Each Municipal Employer has information systems exchanges and testing to be done with the GIC, subscriber communications to disseminate, multiple implementation meetings to attend, eligibility verification and documents to be collected for all subscribers and their dependents, fiscal arrangements, and enrollment activities -- all of which must be completed before coverage can begin.

If Municipal Employers miss the notice deadline

Municipal Employers may file their required documents no later than the next deadline for the corresponding effective date.

Where notices of intent to join GIC coverage are sent

All notices must be sent to:

Executive Director

Group Insurance Commission

P.O. Box 8747

Boston, MA 02114

Participating Municipalities, Regional School Districts, Charter Schools and Planning Councils

List of Participating Municipalities that Offer GIC Health Insurance

Municipalities That Have Joined the GIC's Health Insurance Program to: The following municipalities, school districts and collaboratives are enrolled in the GIC for health insurance coverage.

GIC Municipal Map – a visual map of municipalities that are enrolled in GIC health insurance benefits effective July 1, 2018.

Cities - 11

Framingham (effective 7/1/14)
Gloucester (effective 1/1/14)
Haverhill (effective 7/1/17)
Lawrence (effective 11/1/10)
Lowell (effective 7/1/12)
Medford (effective 1/1/12)
Melrose (effective 7/1/09)
Northampton (effective 1/1/14)
Salem (effective 7/1/12)
Somerville (effective 1/1/12)
Springfield (effective 1/1/07)

Towns - 30

Arlington (effective 1/1/12)
Ashland (effective 7/1/15)
Bedford (effective 7/1/12)
Brookline (effective 7/1/10)
Dracut (effective 7/1/13)
East Bridgewater (effective 7/1/14)
Easton (effective 7/1/15)
Groveland (effective 7/1/08)
Hingham (effective 7/1/17)
Holbrook (effective 7/1/08)
Hopedale (effective 7/1/10)
Lexington (effective 7/1/12)
Lynnfield (effective 11/1/11)
Marblehead (effective 7/1/12)
Middleborough (effective 7/1/14)
Millis (effective 7/1/08)
Monson (effective 7/1/12)
North Andover (effective 1/1/14)
Norwood (effective 7/1/09)
Randolph (effective 7/1/09)
Stoneham (effective 7/1/09)
Sudbury (effective 7/1/12)
Swampscott (effective 7/1/09)
Wakefield (effective 1/1/12)
Watertown (effective 7/1/09)
Weston (effective 7/1/09)
Westwood (effective 7/1/15)
Weymouth (effective 7/1/09)
Winchendon(effective 7/1/16)
Winthrop (effective 7/1/08)

School Districts and Union Collaboratives - 9

Athol-Royalston School District (effective 7/1/08)
Blue Hills Vocational School District (effective 7/1/09)
Gill-Montague Regional School District (effective 7/1/08)
Groton-Dunstable Regional School District (effective 7/1/09)
Hawlemont Regional School District (effective 7/1/08)
LABBB Collaborative (effective 7/1/15)
Mohawk Trail Regional School District (effective 7/1/08)
Northeast Metropolitan Regional Vocational School District (effective 7/1/12)
Pentucket Regional School District (effective 7/1/16)

Regional Districts - 2

Nashoba Valley Regional Dispatch District (effective 7/1/13)
South Essex Sewerage District (effective 1/1/15)

Charter Schools & Planning Councils and Commissions and Non-Union Collaboratives (eligible for all GIC benefits) - 6

Charms Collaborative (effective 7/1/15-6/30/17)
Merrimack Valley Planning Commission (effective 7/1/10)
Old Colony Planning Council (effective 7/1/08)
Pioneer Valley Planning Commission (effective 7/1/09)
Southeastern Regional Planning and Economic Development District (effective 7/1/08)
Valley Collaborative (effective 7/1/15)

Participating Municipalities That Offer GIC Retiree Dental Plan

If your Municipality is not listed, you are not eligible for GIC Retiree Dental benefits. Contact your Municipal Benefits Office for additional information.

The following municipalities offer the GIC Retiree Dental Plan

Cities - 1

Melrose (effective 7/1/13)

Towns - 14

Ashland (effective 7/1/15)
Bedford (effective 7/1/13)
Brookline (effective 7/1/13)
Holbrook (effective 7/1/13)
Holden (effective 7/1/13)
Hopedale (effective 7/1/13)
Middleborough (effective 7/1/15)
Millis (effective 7/1/13)
North Andover (effective 7/1/14)
Randolph (effective 7/1/13)
Swampscott (1/1/16)
Weston (effective 7/1/15)
Westwood (effective 7/1/16)
Winchendon (effective 7/1/16)

School Districts - 2

Athol Roylston School District (effective 7/1/13)
Northeast Regional Technical School (effective 7/1/13)

The deadline for municipalities to notify the GIC to join the GIC Retiree Dental Plan for January 1, 2019, is July 1, 2018.

New Municipal Members

The documentation eligible municipal employees, retirees, and survivors must provide with their initial GIC enrollment form

A list of required documentation that must accompany an initial GIC enrollment form is located in the Initial Municipal Forms section of this website.

The GIC does offer health plans that are available to retirees and survivors who live outside of Massachusetts

For Non-Medicare retirees and survivors, the GIC offers the UniCare Indemnity Plan/Basic that is available throughout the United States and outside of the country.  For Medicare members, the GIC offers Harvard Pilgrim Medicare Enhance, available throughout the United States, and UniCare Indemnity Plan/Medicare Extension (OME), available throughout the United States and outside of the country.  Additionally, many of the GIC’s health plans are available in other New England States.  See the plan pages of this website for details.

What you need to do if your municipality will be joining the GIC and you or your covered spouse are Medicare eligible, but not enrolled

As of 2011, the state requires all eligible municipal retirees and survivors to enroll in Medicare.  You and/or your covered spouse who is eligible for Medicare Part A for free must enroll in Medicare Part A and Part B during the federal government’s open enrollment period of January 1 through March 31 of each year if you, the insured are retired.  If your municipality is joining the GIC in July, enroll in Medicare during the preceding winter federal enrollment period and then enroll in a GIC Medicare Plan during open enrollment.  (If you or your covered spouse is under age 65, refer to the combination coverage section for the Medicare/Non-Medicare coverage combination options.)  If your municipality joins the GIC during the fall, and you missed the federal government open enrollment period, you will enroll in a GIC non-Medicare plan during the special open enrollment period, enroll in Medicare Part A and Part B during Social Security's general Enrollment, and then enroll in a GIC Medicare Plan during the GIC’s spring annual enrollment period.  Any federal Medicare late enrollment fees will be paid by your municipality providing you enroll during the required timeframe.

The surplus or deficit does not get passed along to participating municipalities and their members if the GIC has a budget surplus or deficit

If there is a surplus, it goes to the Commonwealth’s General Fund.  Alternately, if the GIC has a deficit, supplemental funds are requested from the legislature; there is no attempt made to recoup the extra money needed from the municipalities.  Surpluses and deficits have occurred in almost equal number over the years.

How to transfer your mail order prescription drugs to your new health plan’s prescription drug program

To save money on your maintenance medications, you will need to submit a new 90-day supply prescription to your health plan’s prescription drug program.  Drug programs do not usually transfer prescriptions or drug histories.  Your health plan or prescription drug welcome kit will include a mail order envelope for you to enclose mail order prescriptions.  Contact your plan for additional assistance.

Why the GIC does not offer Blue Cross Blue Shield

Blue Cross Blue Shield did not bid on the GIC’s business during the last several health plan procurements.  The GIC conducts a competitive and open bidding process every five years and any and all health plans can submit bids.

The GIC can change copays and deductibles mid year, but it is unlikely

In the last 22 years, the GIC has only had to change benefits mid year two times, due to serious budget shortfalls.  A recently enacted law (G.L.C.32A,S.6) prohibits the GIC from changing copays and deductibles mid year, with the exception of certain Medicare plans that are subject to federal approval.  Note, however, that a plan can change drug formularies during the year, which can affect your copays.

Additional Resources

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
19 Staniford St
Boston, MA 02114
Mailing Address
P.O. Box 8747
Boston, MA 02114
Image credits:  George Headley

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