Learn More About General Benefits and Eligibility

An overview of benefit eligibility and where to find benefit details including provider, gym membership discounts, and other information not included on this website.

Updated on May 10, 2017

For GIC benefit purposes, employers qualify as a state agency

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. Benefit eligibility rules apply.  See the GIC Coordinator list for a list of all participating agencies.

Where to find out details about GIC benefit eligibility

Refer to the GIC’s regulations for details on GIC benefit eligibility.

How to find out if I qualify as a participating municipal employee and retiree for GIC health insurance purposes

If you work for a participating municipality and work at least 18.75 hours in a 37.5-hour workweek or 20 hours in a 40-hour workweek, and participate in a public retirement system, you are eligible for GIC health insurance 

Eligibility for GIC benefits besides health insurance as a municipal employee or retiree

State law provides for participating municipalities to only offer GIC health insurance, and at a municipality’s election, to also offer the GIC Retiree Dental Plan. benefits.  Retirees from participating municipalities that receive a pension from a public retirement system that participates in the GIC are also eligible.  COBRA is not a GIC participating pension system.

Where to find out which doctors and hospitals are in a GIC health plan

Search for doctors and hospitals included in each GIC health plan’s network on each GIC health plan’s website or by calling the health plan’s customer service units.

Where to find your doctor’s or hospital’s copay tier information

Doctor and hospital tiering designations are listed on each GIC health plan’s website or by calling their customer service units. Be sure to specify the health plan name, such as Harvard Pilgrim Independence Plan or Harvard Pilgrim Primary Choice Plan.

Where to find prescription drug copay tier information

Prescription drug copay information is available on the GIC health plan’s or Prescription drug plan website or by calling their customer service units. GIC plans have an abbreviated prescription drug formulary on their website.  Access on your phone or make copies and bring it with you to all doctor visits.

How to find out about gym membership discounts, acupuncture, chiropractor, or other health insurance benefits

Contact your health plan  and the individual health plan pages for your health plan handbook, which contains these details.

Where to get a gym reimbursement form

Gym reimbursement forms are available through your GIC health plan.

Where to get a health insurance claims reimbursement form

Health insurance claims reimbursement forms are available through your GIC health plan.

Where to find out how much you have paid out-of-pocket for health care costs

Many of the GIC’s health plans offer online access to the claims that have been paid on your behalf and the costs you have paid out of pocket.  Contact your GIC health plan for details.

Where to find heath care cost information for different providers

All GIC health plans now have an online cost comparison tool on their websites.  See your Health Plans Website or Get the Deal on Care to access your plan's cost estimates tool.

Who you contact for a new card if you have misplaced your health or prescription drug ID card

Contact your health or prescription drug plan for another ID card and for additional ID cards for family members.

If you are a state employee or retiree you cannot opt out of GIC basic life insurance

You may only opt out of life insurance if you also decline health insurance. Under statute (Chapter 32A) state employees and retirees are required to have basic life insurance when electing to enroll in GIC health insurance.

How to arrange to receive the insured’s GIC benefit information if you have a Durable Power of Attorney as a state/municipal employee or retiree

Send a copy of your Power of Attorney (POA) to the attention of the Public Information Unit at the GIC, P.O. Box 8747, Boston, MA  02114.  If you are also requesting a change of address for the insured, for example because you want the insured’s information to be sent to your address, send the address change request with the POA.  Note that only those with a Power of Attorney can make changes to the insured’s coverage.  Remember only a Durable Power of Attorney remains in effect for an incapacitated person.

GIC health insurance benefit deductions made on a pre or post tax basis

The Commonwealth’s Section 125 Plan allows for pretax health insurance benefits for employees.  Employees can elect out of this option as a new hire or during Annual Enrollment through their payroll department.  Retiree and survivor health insurance pension deductions are made on a post-tax basis.   Retirees should discuss with their tax advisor whether these payments are tax deductible for purposes of tax filing.

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.

You can re-enroll in health insurance if you allowed your GIC health insurance coverage to lapse by not paying the monthly premium

You can only re-enroll in GIC health insurance during the GIC’s spring Annual Enrollment period for coverage effective the following July 1.  Complete enrollment forms and attach required documentation as outlined on the forms and return no later than the end of the annual enrollment period.  Active employees, return to your agency’s/municipality’s GIC Benefit Coordinator; Retirees and Survivors, send to the GIC, P.O. Box 8747, Boston, MA  02114.

How to seek routine care if you are a UniCare State Indemnity Plan/Basic member and live outside Massachusetts for all or part of the year

Contact UniCare  (1-800-442-9300) about their Travel Access Program.  This program protects members from being balance billed for covered services by a non-Massachusetts provider.

How to find out which mental health providers are in UniCare State Indemnity Plans, Tufts Navigator or Spirit 

Mental health and substance abuse benefits for the UniCare State Indemnity Plans, Tufts Navigator and Tufts Spirit are provided by Beacon Health Strategies.  Contact Beacon for network provider details.  If you are in another GIC health plan, contact your health plan for network providers. 

If you are enrolled in one of the UniCare State Indemnity Plans you do not have to use CVS retail pharmacies for your prescription drugs

CVS Caremark is the prescription drug benefit manager for the UniCare State Indemnity Plans.  Members can use any participating pharmacy to fill their prescriptions, including CVS, Walmart, Walgreen’s, Rite Aid and others.  Use CVS Caremark’s pharmacy locator to find a participating pharmacy near you.  For maintenance medications, use the CVS Caremark mail order service to save money on your co-pays.  Or, you may elect to get your maintenance medications at a CVS retail pharmacy with the mail order copay.

The GIC does not offer short term disability insurance

The GIC does not offer short term disability insurance.  Contact your benefit office to see if a short term disability program is available to you.

Where to find GIC dental/vision or Retiree Dental list of participating providers

Network dentists are listed on the dental provider's website or by calling their customer service unit. Vision providers are on the vision provider's  website or by calling their customer service unit.

Where to get information on dental and vision insurance as a state employee that is not eligible for GIC Dental/Vision

Most unions offer a dental and/or vision benefit.  Contact your benefits office for details.


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