Eligibility and Coverage
Updated June, 2018
Eligiblility for GIC benefits
Additionally, certain municipalities through the collective bargaining process, have elected to join the GIC’s health insurance benefits as a participating municipality. Certain municipalities also offer the GIC Retiree Dental Plan. Other municipalities have opted to insure their retired teachers through the GIC’s Retired Municipal Teacher program.
To be eligible for GIC health insurance, a state employee or participating municipal employee must work a minimum of 18 ¾ hours in a 37.5 hour workweek or 20 hours in a 40 hour workweek. Employees working less than 18.75 hours per week are not eligible. The employee must contribute to a participating GIC retirement system, such as the State Board of Retirement, a municipal retirement board, the Teachers Retirement Board, the Optional Retirement Pension System for Higher Education, a Housing, Redevelopment Retirement Plan, or another Massachusetts public sector retirement system (OBRA is not such a public retirement system for this purpose). Temporary employees, substitute teachers, contractors, employees working less than 18.75 hours per week, and most seasonal employees are not eligible for GIC health insurance benefits.
Employment and Eligibility Information
For GIC benefit purposes, you qualify for state employee or retiree benefits if you are working or retired from the Commonwealth’s Executive Branch, Judiciary, Legislature, UMass and Other State Colleges and Universities, Housing, Redevelopment and Certain Other Authorities. Refer to the GIC’s regulations for details on GIC benefit eligibility. See the GIC Coordinator List for a list of all participating agencies.
When GIC benefits begin for new employees
GIC benefits begin on the first day of the month following 60 days or two full calendar months of employment, whichever comes first. The Dependent Care Assistance Program (DCAP) begins on the first day of employment. Enrollment forms must be completed and returned to your GIC Coordinator within 10 calendar days of hire. If you miss this deadline, you must wait until the next Annual Enrollment period to enroll in GIC health insurance benefits.
For state employees, your basic life and health insurance benefits are on a pre-tax basis unless you opt out. GIC benefits for state employees can include: basic life, basic life and health insurance, long term disability, optional life insurance, dental/vision for employees not covered by collective bargaining, (primarily managers, Legislators, Legislative and certain Executive Office staff), and several GIC pre-tax programs: the Health Care Spending Account (HCSA) Program and the Dependent Care Assistance Program (DCAP). Participating Municipal employees are eligible for health benefits only.
Whom to contact about electing GIC health insurance deductions on a post or pre-tax basis
As a new employee you will be automatically enrolled in pre-tax health insurance deductions unless you elect to have them deducted on a post tax basis. During Annual Enrollment you can elect to change from pre-tax to post tax or post tax to pre-tax deductions effective the following July 1. See your payroll department to make these elections and changes.
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 (state and municipal employees) will begin on the first day of the month following 60 days or two full calendar months of the day you begin working the required hours for benefits
Most other state employee benefits (basic life, long term disability, optional life insurance, GIC dental/vision (if eligible) and the Health Care Spending have the same waiting period. Only the Dependent Care Assistance Program (DCAP) is effective as of your date of becoming eligibl.
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. Contact the GIC’s Public Information Unit at 617.727.2310 for more information.
What happens to GIC benefits if 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
Your GIC coverage will end at the end of the month after your hours are reduced provided your premium for that month is paid. You may elect to continue coverage through the Health Connector, GIC COBRA or non-group conversion through your health plan.
If you are an active GIC-eligible employee and also retired from a state agency/authority or participating municipality and eligible for GIC retirement benefits; you cannot choose both employee and retiree benefits
You must choose active employee or retiree benefits; you may not have benefits under both statuses. Contact the GIC 617.727.2310 to indicate whether you want employee or retiree benefits.
If you are an active GIC-eligible employee and also the dependent of a GIC-eligible state or participating municipal employee/retiree; you cannot choose both employee and dependent benefits
You must choose active employee or dependent benefits; you may not have benefits under both statuses.
If you work for the state, participating GIC authority or municipality and transfer to another GIC agency or municipality; you may be subject to the 60-day new hire waiting period
Because your premiums are paid a month in advance, your coverage terminates at the end of the following month after you leave (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 your existing coverage will remain in force and you will not be subject to the 60-day waiting period. You must remain in the same health plan. If you were not enrolled in GIC health insurance at the time of this transfer you must wait until the next annual enrollment period to enroll.
State employees who were not enrolled in Long Term Disability or Optional Life may apply for these benefits subject to evidence of insurability. Or, if you were enrolled in these benefits they will continue. Note that if you are transferring to a participating municipality, you are only eligible to transfer your GIC health insurance benefits.
If you are hired by another agency/participating municipality after the coverage end date, you are not considered a transfer and are subject to the 60-day new hire waiting period.
If you were covered by a bargaining unit dental plan. You are subject to a waiting period when you become a manager and join the GIC Dental/Vision Plan
If the GIC receives your completed Dental/Vision enrollment form within 60 days of the position change, the effective date will be the first day of the second month following the position change. If we do not receive the completed form within 60 days of the position change, you must wait until the GIC’s next Annual Enrollment period to enroll.
If you were just hired to work for the state and used to work for the state before; the premium contribution you will pay for basic life and health insurance may differ
If you were hired by the state before July 1, 2003, and have been rehired within two years of your termination date, you pay 20%. If you return to work with the state more than two years from the termination date, you pay 25%. For other scenarios, please visit the answers to common questions - employment status change section of our website.
If your salary changes, it may affect your costs for any GIC benefits
Premiums and benefits for optional life insurance and/or Long Term Disability coverage are based on salary and age. See the rate section for details.
If you work for an authority or state agency that is offering non-union Health Insurance, Long Term Disability or Life Insurance benefits through a non GIC vendor; this is not allowed
All state agencies including housing and redevelopment agencies who provide GIC benefits to their employees cannot offer any benefits through non-GIC carriers if the GIC provides these benefits. Refer your agency’s legal counsel to Section 5.02 of the GIC regulations for additional details.