Allocation of Responsibilities

After the transfer, responsibilities of the municipality and the GIC.

Frequently Asked Questions

Revised on 7/19/2017

Once the municipality transfers to the GIC, what are the responsibilities of the municipality and the GIC?

The municipality is responsible for ensuring their employees, retirees, and survivors pay their share of the premium of the health plan in which they enrolled through payroll and pensions deductions, or through billing.  The municipality reconciles its monthly GIC reports and remits the enrollee and employer share of the premium, including the administrative fee, no later than the due date.  The municipality is responsible for disseminating the GIC’s communications to its employees; the GIC will send communications to the municipal retirees and survivors.  The municipality also processes and notifies the GIC of all new hire and Employment Status Change  using the GIC’s forms and procedures. 

The GIC will administer COBRA benefits, dependent age 19 to 26 status changes, retirees and covered spouses turning age 65, and the transition to a Medicare plan.  The GIC will also determine eligibility and effective dates, and will distribute Medicare Part D creditable coverage notices. The GIC will determine the effective date for all matters pertaining to insureds' and eligible dependents' health coverage, including but not limited to effective dates of coverage, termination, and status changes.  The GIC will also determine whether persons are eligible for Commission coverage, and its eligibility decisions are final and binding.

Is the GIC responsible for the biannual health insurance eligibility audits mandated by Section 26 of Chapter 32B?

No; that responsibility rests with the Municipal Employer. In addition, A list of insureds (though not dependents) is sent each month as part of the municipality’s bill.  These rosters must be reconciled monthly by the municipality to identify any discrepancies between the GIC’s enrollment files and the municipality’s list of eligible enrollee to ensure billing accuracy.

However, if a Municipal Employer makes a written request to the GIC’s municipal coordinator by November 15 of a particular year, the GIC will make available to the municipality a list of current enrollees, including all dependents, on or before the following January 15.

How long after the  Fiscal Year ends do municipalities receive their share of the Medicare  Part D subsidy?

Municipalities receive their share of the Medicare Part D subsidy after the reconciliation process, which is approximately 18 months after the Fiscal Year closes. Note that with the implementation of the EGWP program in 2016, these subsidies will be eliminated after the runout period. 

For additional details, see the GIC Municipal Health Coverage regulations.

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