- Group Insurance Commission
The new July 1st plan year marks the beginning of a new health insurance contract cycle, and as a result of this, and the merger of Tufts Health Plan and Harvard Pilgrim Health Care into Point32 Health, there are changes to the health insurance plans available to GIC members for benefits effective July 1, 2023.
The GIC encourages all members to actively shop and evaluate health coverage options during Annual Enrollment (April 5 - May 3, 2023) or when experiencing a qualifying event to enroll in or update benefits. If you are currently enrolled in a health insurance plan that is being discontinued in Fiscal Year 2024 (FY2024) and you do not choose a new plan, you will automatically be default enrolled in a comparable health insurance plan. FY2024 health insurance plan placement options are outlined in the GIC Benefit Guides.
After evaluating your options, if you do not want to select a different health insurance plan than the one you are being defaulted into during GIC's Annual Enrollment, no further action is needed. However, if you want to select a different health insurance plan, be sure to submit your changes to the GIC no later than May 3, 2023.
When deciding what product is right for you, it is important to consider the following:
- Where will you and your dependents be living during the upcoming benefits plan year?
Where you live determines which health insurance plan you may enroll in. Please review the health insurance locator map and other important information in the GIC Benefit Guides to determine which plan you are eligible to enroll in. Make sure your plan’s provider network includes your area of residence prior to enrollment.
- What type of network coverage do you need? (National, Broad, Regional, Limited)
Learn about the different types of network coverages listed in the GIC Glossary.
- Are your doctors and hospitals in the health plan’s network?
Make a list of the doctors and hospitals you visit and check if they're listed as in-network for the health insurance plans you're exploring by reviewing the health plan's doctor/provider directories and hospital lists available on each health plan's website.
- Which tier are your doctors and hospitals in?
Even if your doctors and hospitals are in-network for the health plans you're exploring, they might fall into different tiers (1,2,3) for different health plans. The tier they fall in determines things like how much your copay will be per visit. For example, a tier one doctor's visit will have a lower copay than a tier three doctor's visit. Learn what tier your doctors and hospitals are in by reviewing the health plan's doctor/provider directories and hospital lists available on each health plan's website.
- If there are new doctors you would like to see, which of those doctors in the network are accepting new patients?
After making sure the doctors you see are in the network, don't forget to check that the doctors you plan to see during the plan year are also in the health plan's network and are accepting new patients; if they are not, be sure select a doctor that is accepting new patients. To verify this, you can call the doctor's office directly to confirm that the doctors participate.
Contact the health insurance plans you're evaluating to ask questions about guidance or assistance regarding health plan benefits and coverage, cost, finding a provider, and more.