Who Municipal Employers Must Cover

Details on who is covered and eligibility.

Revised on 7/19/2017

Municipal Employers must transfer all of their subscribers to GIC health coverage, and may not enroll only certain groups

Section 19 and Section 23 both require that Municipal Employers enroll all of their GIC-eligible subscribers, including Retired Municipal Teachers and Elderly Governmental Retirees already covered by the GIC through the RMT and EGR programs, in GIC health coverage.  For further information relevant to municipalities with RMTs or EGRs, please see Section IV, Retired Municipal Teacher (RMT) And Elderly Governmental Retiree (EGR) Programs, below.

Municipal Employers must cover their retirees, survivors and dependents if they decide to join GIC coverage

All GIC eligible active employees, retired employees, survivors and their dependents, including all Retired Municipal Teachers and Elderly Governmental Retirees, must be offered GIC health insurance coverage.

Eligibility as an “Employee” may change if a municipality joins the GIC

The GIC’s regulations require that all retirees and all employees other than elected officials enrolled via Section 19 must participate in a qualifying public pension system.  Participating Municipal Employers must generally offer insurance to pension-eligible municipal employees who work more than 20 hours in a 40 hour work week, or 18.75 in a 37.5 hour work week.  In no case is someone eligible if they work less than 18.75 hours. These requirements may impact eligibility for some participating municipalities.

Additionally, when a Municipal Employer transfers subscribers to the GIC, the GIC takes on the role of making final eligibility determinations.  If the GIC concludes that a person is not eligible, that decision is final.  This may result in the denial of eligibility for people who have been covered in the past. 


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