Commonly asked questions for GIC members
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Frequently Asked Questions
Table of Contents
General
Q: Will there be information available about the cost of my health insurance coverage at the Public Information Sessions?
Costs for Fiscal Year healthcare benefits will be available on GIC’s Benefit Guides immediately before GIC’s Annual Enrollment at the beginning of April.
Q. How can I view and update my benefits?
Save time and paper by viewing your benefits online 24/7 and making changes or corrections to your benefits on the MyGICLink Member Benefits Portal.
Q. When will Benefit Guides be available online?
The new Benefit Guides will be available immediately before GIC’s Annual Enrollment, April 5 - May 3, 2023, on our website. These guides provide GIC members with important benefit information for the upcoming benefits year (July 1, 2023 – June 30, 2024), including health insurance plan comparisons, rates, copays, important reminders, and more.
Q: How can I find out what health insurance terms like POS, PPO, HMO, Network, deductible, copay, and more mean?
Please visit GIC’s Glossary to learn about commonly used terms by the GIC.
Q: Will the GIC be offering in-person health fairs?
Every year the GIC offers virtual health fairs, available immediately before Annual Enrollment begins.
Q: Can I use MyGICLink Member Benefits Portal for Annual Enrollment?
Members should register for MyGICLink before then in preparation for Annual Enrollment. GIC state and municipal employees and retirees can enroll in or update GIC benefits using MyGICLink Member Benefits Portal.
GIC Retired Municipal Teachers (RMT), survivors, and other members have the option to update GIC benefits using GIC Online Forms. Please make sure to include an up-to-date email address when completing your form(s) to receive a registration email when MyGICLink becomes available to you. For more information, visit bit.ly/Mygiclink.
Q: Is there a mobile phone app for the MyGICLink Member Benefits portal?
No, but you can access MyGICLink on your mobile phone by going to mass.gov/mygiclink-member-benefits-portal; it is mobile-friendly.
Q: What is the number at GIC if you need to speak to someone regarding your specific circumstances?
The GIC's phone number is 617-727-2310.
Q. How can I sign up for MyGICLink? What should do if I don’t know my pin?
Registration and pin instructions can be found here: https://www.mass.gov/guides/mygiclink-member-benefits-portal-resources. How to register & login video tutorial Register & Login To MyGICLink. Note: Make sure to provide the GIC with an up-to-date personal email address to receive a registration email for MyGICLink and to continue to have access to MyGICLink if you change agencies and once you retire.
Q: Does GIC hold Public Information Sessions for GIC Coordinators?
GIC provides GIC Coordinators with an Annual Enrollment training presentation immediately before Annual Enrollment every year.
Q: What regional school districts participate in GIC?
A list of participating municipalities and regional school districts can be found on GIC's website at mass.gov/info-details/gic-participating-municipalities.
Q: Does mental health fall under behavioral health?
Yes.
Q. How can I find what network/tiers my hospitals are in?
You may review the GIC’s hospital list for coverage information for each GIC health insurance plan. Be sure to consult the health plan's online provider directory or call the plan directly for more information on individual providers (e.g., tier designation and hospital admitting privileges). Find your health plan’s website at https://www.mass.gov/lists/gic-benefits-contact-information.
Q. If I enroll in or update GIC benefits during Annual Enrollment, when will my benefits be active?
The GIC plan year begins July 1st and ends on June 30th of every year. If you enroll in a health insurance plan during Annual Enrollment, your health insurance benefits will be effective July 1, 2023. *New hires must complete the waiting period before coverage is effective.
Q. If I am eligible for GIC benefits but not currently a GIC member how should I enroll in GIC benefits?
You may enroll in GIC Benefits during Annual Enrollment or within 60 days of a Qualifying Event.
Q. What are eligible qualifying events to update or enroll in GIC benefits?
Please review the Qualifying Events page for a full list of qualifying events to update or enroll in GIC benefits.
Q. If I am a state or municipal employee, how can I confirm if I’m eligible for GIC benefits?
Verify eligibility by reviewing the GIC benefits coordinator list and by contacting your GIC coordinator. If eligible, your GIC coordinator can explain what benefits you’re eligible for and help you enroll in benefits for the first time. Note: When you apply make sure to provide the GIC with an up-to-date personal email address to receive a registration email for MyGICLink.
Health Insurance Plans
Some GIC health plans are changing for the upcoming Fiscal Year. For a list of plans that are changing, please review the GIC Benefit Guides. If your plan is changing, if you do nothing, you will be enrolled in a health plan comparable to the health plan you’re currently enrolled in. For a list of health plan transitions, please review the GIC Benefit Guides.
The GIC encourages GIC members to review GIC Benefit Guides to actively shop and evaluate different coverage options during the spring Annual Enrollment period for coverage effective July 1st.
Q: Will all the GIC’s current five health insurance carriers be offered for Fiscal Year 2024 (FY2024 - July 1, 2023 - June 30, 2024)?
Yes, however, because Tufts Health Plan and Harvard Pilgrim Health Care have merged together under a new organization, called Point32Health, there will be four health insurance carriers beginning in FY2024.
The GIC strongly encourages members to review GIC Benefit Guides to actively shop and evaluate different coverage options during the upcoming 2023 Annual Enrollment period for coverage effective July 1, 2023.
Q: Will there be materials available about the FY2024 plan design & rate recommendations?
Proposed plan design recommendations were presented at the January commission meeting. The Commission will vote on the proposed recommendations for FY2024 in February & March.
FY2024 plan designs and rates will be available on GIC Benefit Guides immediately before GIC’s Annual Enrollment in the beginning of April.
Q: I am having an issue with my health insurance carrier. What should I do?
GIC takes member privacy seriously and advises against using the listening sessions as public forum at which to discuss your personal health care matters. Members seeking assistance or guidance regarding an insurance matter should contact their health insurance carrier by visiting mass.gov/lists/gic-carrier-contact-information or dialing the phone number on the back of their card.
Q: I have a question regarding a health insurance claim or I need a health insurance card. What should I do?
GIC takes member privacy seriously and advises against using the listening sessions as public forum at which to discuss your personal health care matters. Contact your health insurance carrier by visiting mass.gov/lists/gic-carrier-contact-information.
Q. When will I get a new health insurance card when I change plans as of July 1, 2023?
Members that change plans during Annual Enrollment should receive new ID cards in June 2023 before the July 1, 2023 effective date.
Q: Does the GIC offer a +1 health plan in addition to individual and family coverage?
The GIC has investigated offering an individual plus one plan as well as an employee plus children plan. The challenge that the GIC would have in offering these, is that the premiums for families would skyrocket. Broadly speaking, GIC members tend to cover more family members than other employer-sponsored plans, including other public sector health plans.
The GIC will continue to evaluate its coverage tiers each year, and if it is determined that such a change would be advantageous to the GIC’s membership at large, it could be implemented in the future.
Q: Will the healthcare plans still cover telehealth? (And will it be the same telehealth providers?)
Yes, telehealth will still be covered and health plans may utilize the same or new telemedicine subcontractors as their providers; please reach out to your health plan for more information at mass.gov/lists/gic-benefits-contact-information.
Q: Is there a maximum number of people that can be added to a family plan?
No.
Q: Where would I find the deductibles for each plan?
Please review the GIC Benefit Guides.
Q: Is UniCare the only health plan that covers non-emergency services outside of the US?
Yes.
Q: If I switch providers will pre-existing conditions be covered?
Yes.
Q: Who do I contact to find out if a medical procedure is covered?
Contact your health plan for coverage and cost information.
Q: Does GIC offer High Deductible health insurance plans?
No.
Q: I recently moved out of Massachusetts, am I limited to a provider who offers coverage in my area, or can I choose another provider and drive to that service area?
You must reside in your health plan's service area to be eligible for the plan.
Q: Once my dependent turns 26 and is no longer covered under the GIC plan, what will I need to do in order to remove them from my plan and lower my cost?
Enrolled dependents that reach age 26 are automatically removed from a GIC member's health plan at the end of the month of their 26th birthday.
Q: Can I have Harvard Pilgrim's Access America while working remotely while traveling but keeping my Massachusetts address? Are there limitations for remote working that we need to think about?
Enrollment eligibility is based on permanent residence on record with the GIC. There are multiple broad network plans available to GIC members that offer coverage to in-network providers nationwide to GIC members who reside in New England.
Q: If you live in Massachusetts and belong to UniCare Basic now, do you have to do anything during Annual Enrollment to continue the plan?
No, if you are currently in Unicare Basic and want to stay, you can. The difference is that there's a name change from Basic to Total Choice. With the exception of a few tiering and copay (copay changes to freestanding surgery centers that do eye surgery and GI surgeries) changes, it's the same plan.
Q: Does a dependent moving to a state outside of New England (not for college) under the age of 26 still qualify to be covered as long as the "member" lives in MA?
Yes, the dependent under age 26 still qualifies and must follow the plan's rules for coverage outside of the service area.
Q: Is there consideration to cover acupuncture services?
Acupuncture coverage is under consideration for future health plan design changes.
Q: If you use Unicare plan plus, can you live out of the region?
Please consult the coverage map that will be included in the Benefits Guide. Your main residence must be within the PLUS region.
Q: When I enroll in a health plan, how long does it take for it to be active?
Coverage activates at different periods depending on when you enroll.
For new employees, most benefits become effective the first of the month following 60 days of employment.
During annual enrollment, coverage enrollments or changes become effective on July 1.
For qualifying events, coverage becomes effective the day of your qualifying event. Please be sure to enroll or update coverage within 60 days of your qualifying event.
Q: What is the best way to find out if our providers are covered and what their copay would be, as we try to decide which health plan to choose?
Review GIC’s Benefit Guides and contact the health plans and view their provider directories at mass.gov/lists/gic-benefits-contact-information.
Q. Did the UniCare Medicare Extension OME CIC change its name and if so, what is it?
The health plan name will be UniCare Medicare Extension as of July 1, 2023.
Q. I have the Tufts Complement health plan. Will this plan change?
This health plan will no longer be available as of July 1, 2023 and members will be automatically enrolled in the Harvard Medicare Enhance plan unless another plan is selected during Annual Enrollment.
It is important to evaluate your options and select a health plan that meets your needs. After evaluating your options, if you do not want to select a different health plan during Annual Enrollment, no further action is needed. FY2024 health plan placement options are outlined in the GIC’s Benefit Guides.
Q. The UniCare Basic Plan currently doesn’t require out of state non-Medicare retirees to have a Primary Care Provider (PCP) and does not require referrals. Will either of these change with Harvard Pilgrim Access America?
This will not change with Harvard Pilgrim Access America.
Q. If a dependent lives outside of New England, but the enrollee lives in New England, what are their plan options?
Please review the health insurance locator map in the GIC Benefit Guides to determine which plan(s) you may enroll in.
If you are an MA or New England resident who covers dependent family members who live in a different state (whether full-time or as a student), you may pick between the UniCare Total Choice, UniCare Plus and Harvard Pilgrim Explorer plans. These plans have national networks that can be used for enrolled family members residing outside of New England; contact the health plans for details regarding their national networks/out-of-area coverage and for information regarding behavioral health benefits.
Q. What are my health plan options if I live outside of New England?
Harvard Pilgrim Access America
Q. If a member's plan is ending June 30, 2023, and they want to enroll in the default plan, what do they need to do?
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.
Q. What health plan is available for those living outside of the U.S.?
UniCare Total Choice is the only health insurance plan offered by the GIC that is available for members living outside of the U.S.
Q. Do all plans cover emergency services when you are traveling outside of the U.S.?
Yes; please contact your health insurance plan for details.
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Prescription Drug Benefits
Caremark and SilverScript ID cards mailed to subscribers and dependents, regardless of which plan they are enrolled in, will show the subscriber's name.
Note: If dependents covered under CVS Caremark or CVS SilverScript coverage would like to print a card with their name on it, they can go to caremark.com. Upon login, they would select plan & benefits in the toolbar and select print member ID card which would produce a card with that individual’s name.
Q: Will there be any changes to my pharmacy benefits in FY2024?
If you are enrolled in a GIC non-Medicare plan, your pharmacy benefits will change. Pharmacy benefits will be administered by CVS Caremark for both non-Medicare and Medicare plans.
Q: Will all our previous prescriptions at Express Scripts change to CVS Caremark automatically?
Yes.
Q. Can I continue using a non-CVS pharmacy for monthly prescriptions?
Yes. You may use your preferred pharmacy for a 30-day supply of medication. For a complete list of pharmacy options, please view the pharmacy locator map at info.caremark.com/oe/gic.
Please note: CVS Caremark will allow two 30‐day fills for long‐term medications at your regular pharmacy before being asked to switch to 90‐day supplies. If you want to keep filling your long‐term medication prescriptions at your current pharmacy in 30‐day supplies without paying the full cost, you must opt-out once your new plan starts by calling CVS Caremark at (877) 876‐7214, option 2.
Q: Is the new Rx plan mail order or only at CVS stores?
Both options will be available to members, including the use of retail pharmacies other than CVS.
Q: Would there be a price difference if I do not use a CVS retail pharmacy?
CVS pharmacies provide the best savings for GIC members compared to other retailers.
Q. Will there be a new specialty pharmacy with CVS Caremark for non-Medicare prescription benefits?
Yes. Members on specialty medications will need to fill them through CVS Specialty instead of Accredo starting 7/1. Prior authorizations should be transferred. CVS will send information to members to assist with the transition prior to 7/1. Please review the Rx Prescription Drug Benefits page for more information.
Q: Will there be a list of drugs that CVS Caremark covers, and which drugs they will not cover?
Yes; the CVS Caremark formulary will be available on their website on the GIC Benefits Contact Information.
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Dental & Vision Benefits
Q: Can you enroll in dental insurance without enrolling in health insurance?
Yes; GIC dental coverage is available to managers and other employees not covered under a collective bargaining agreement, regardless of whether you participate in health insurance.
Q: Will anything be changing about dental or vision coverage?
No.
Q. Who manages state retiree dental and vision benefits?
For eligible state retirees, GIC offers a Retiree Dental Plan through MetLife and a vision discount program with Davis Vision.
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Flexible Spending Accounts (FSAs)
This benefit is available for active state or municipal employees only.
Q. What is the plan year for the Flexible Spending Account benefit?
FSA plan year information can be found on the Flexible Spending Accounts page.
Q. What types of expenses can an FSA account be used for?
FSA expenses information can be found on the Flexible Spending Accounts page.
Q: Will the dollar amount of the Flexible Spending Accounts (FSAs) be increased to a greater level?
The Medical FSA election limit for Fiscal Year 2024 is $3050. The Dependent Care Assistance Program (DCAP) election limit will remain at $5000 per household.
Q: Benefit Strategies will no longer be the Flexible Spending Account (FSA) provider for the GIC. Will my commuter benefits be affected by this?
The commuter program is a separate program administered by the Office of the Comptroller. Please review their website at macomptroller.org/ for details.
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Disability Insurance Benefits
Q: What disability insurance is offered by the GIC and who is eligible? Is long-term disability insurance available to all state/municipal employees who are eligible for GIC health insurance?
The GIC offers a long-term disability insurance benefit to eligible state employees.
Q: Is there any long-term disability benefit available to municipal employees?
Municipal employees are only eligible for health insurance through the GIC.
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Retirement & Turning 65
Q: I am planning to retire soon. What do I need to do?
GIC members enrolled in a GIC benefit must notify the GIC of their retirement within 60 days of their retirement date by submitting the retirement qualifying event application on the MyGICLink Member Benefits Portal or by completing the GIC Change Form 1A.
If you’re not enrolled in a GIC benefit and you want to apply for GIC benefits for your retirement, you must notify the GIC of your retirement within 60 days of your retirement date by submitting the GIC Change Form RS application. You must also be collecting a monthly pension.
Q. How do I pay for my GIC benefits when I retire?
As a retiree, you will be billed monthly for your benefits until the premium can be deducted from your pension.
Q: I am retiring before Annual Enrollment; will I have to redo all my choices during the Annual Enrollment period?
No; however, the GIC strongly encourages members to review GIC’s Benefit Guides to actively shop and evaluate different coverage options during the upcoming Annual Enrollment period for coverage effective July 1.
Q. I'm going to retire, do I need to enroll separately for the Davis Vision plan?
No. State retirees are eligible and automatically enrolled in the Davis Vision discount program if you are enrolled in GIC benefits.
Q. Can state retirees increase their Basic Life Insurance coverage?
The Basic Life insurance coverage amount cannot be changed or increased.
Medicare
Q: Does the GIC offer a Medicare buy-in for members who do not qualify for Medicare Part A for free?
No. The GIC continues to evaluate options for our non-Medicare eligible retirees. There are significant and serious challenges to calculating and administering the substantial penalty payments required for individuals who do not have enough qualifying quarters of work to participate in Medicare. At this point in time legislative action would be required to fund those penalty payments for impacted retirees and all retirees impacted must agree to enroll in Medicare.
Q: My spouse is turning 65 and will apply for Medicare. What do I have to do about continuing coverage on add-on plans through GIC?
If you are retired, we will contact your spouse three months prior to their 65th birthday with information about applying for Medicare and selecting a GIC Medicare Plan.
Q. My spouse is a state employee retiring before the July 1,2023 plan year. Do we need to choose a Medicare plan during Annual Enrollment? Am I covered as a spouse of a state employee in a Medicare plan?
New retirees who are over age 65 and eligible for Medicare Part A (for free) and Medicare Part B can select a GIC Medicare using the Retirement Event application in the MyGICLink Member Benefits Portal or by completing the Medicare Plan Election form that will be mailed to you when GIC is notified of your official retirement.
Q. My spouse didn't contribute to Social Security as a state employee; do they have to switch to a Medicare health plan at age 65?
Your spouse will have to apply to Social Security Administration (SSA) to determine if they’re eligible for Medicare parts A and B. If they’re not eligible, GIC will require proof of ineligibility from SSA.
Q. Am I eligible for GIC Medicare plans as an employee’s spouse?
Medicare plans are only available to spouses of retired state & municipal members with GIC benefits, age 65 and older.
Q. I am over age 65, still working for the state/municipality and enrolled in GIC benefits, do I need to enroll for a Medicare health plan?
As an active state/municipal employee, you will remain in a non-Medicare plan until retirement.
Please note: FSA is not available to retirees.
Visit our GIC Medicare Enrollment page for information about Medicare enrollment, eligibility, resources for 65+ retirees, and more.
Resources
Flexible Spending Accounts (FSA) For State Employees
Health Insurance Buy-Out Program
How to Enroll In /Update GIC Benefits
Life Insurance and Accidental Death & Dismemberment (AD&D) For State Employees & Retirees
Long-Term Disability for State Employees
Mass4YOU Employee Assistance Program (EAP)
Health Insurance Plans & Prescription Drug Benefits
Non-Medicare Health Insurance Plans (FY2024: For benefits effective July 1, 2023)
Medicare Health Insurance Plans (FY2024: For benefits effective July 1, 2023)
Non-Medicare Health Insurance Plans (FY2023: for benefits prior to June 30,2023)
Medicare Health Insurance Plans (FY2023: for benefits prior to June 30,2023)
Dental & Vision Benefits
Retiree Dental Plan & Vision Discount Plan
State Employee Dental and Vision Plan
Information Session Presentations & Recordings
January 2023 Public Information Session Presentation for all GIC members & recording
March 2023 Annual Enrollment Information Session Presentation for State & Municipal Retirees & recording
March 2023 Annual Enrollment Information Session Presentation for Active State & Municipal Employees (non-retirees) & recording
Don’t see your question answered here? Please contact us using the GIC contact form and a member of our staff will reach out to you with more information. Visit mass.gov/lists/gic-benefits-contact-information for a complete list of your health plan’s FAQs, provider directories, handbooks, and more.