Health & Basic Life Insurance
There are various health care plan choices offered to benefited employees, their spouse, and dependent(s). New Employees are eligible to begin coverage 60 days from the first full month of employment. The definition of a dependent under the dependent age 19 to 26 is a son, daughter, stepson, stepdaughter, adopted child, or eligible foster child. To be eligible for coverage as a foster child, the child must be placed by an authorized placement agency or by judgment, decree, or other order of any court of competent jurisdiction. If you have family coverage and when a child turns age 19, the Group Insurance Commission sends subscribers additional paperwork to complete and return in order to extend insurance for the dependent to age 26.
The Health Care Plans include Indemnity plans, Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), and Exclusive Provider Organization (EPO), HMO-Type. The Commonwealth contributes 75% of the Health Insurance premium and coverage is available to state employees at 25% of the full cost including basic life insurance of $5,000 and an additional $5,000 for accidental death. Employees are eligible for coverage 60 days from the first full month of employment. Health and Basic Life insurance are pre-tax deductions. Open Enrollment gives you an opportunity to review your benefit options and make changes if you desire (no later than late May of each year to be effective on July 1st). Please contact the Human Resources Office for insurance changes outside of the open enrollment period. The following are the health care insurance plan choices:
- Fallon Health Direct Care
- Fallon Health Select Care
- Harvard Pilgrim Independence Plan
- Harvard Pilgrim Primary Choice Plan
- Health New England
- NHP Care (Neighborhood Health Plan)
- Tufts Health Plan Navigator
- Tufts Health Plan Spirit
- UniCare State Indemnity Plan/Basic with CIC (Comprehensive)
- UniCare State Indemnity Plan/Basic without CIC (Non-Comprehensive)
- UniCare State Indemnity Plan/Community Choice
- UniCare State Indemnity Plan/Plus
Each plan has a calendar year deductible, a fixed dollar amount you must pay each calendar year before your health plan begins paying benefits. Certain services do not apply towards the deductible. There are in-network deductibles plus members have a separate calendar year deductible for services received from out-of-network providers. Co-pays apply for all services. Each plan provides benefits for prescription drugs using a three-tier co-payment structure in which copayments vary, depending on the drug dispensed. The program consists of generic, brand name and mail-order prescriptions. Visit Group Insurance Commission Health Plans for Active Employees for more specific information on health plan deductibles and co-pays as well as prescription drugs.
Optional Life Insurance
Life insurance, insured by MetLife. Rates are based on age and amount of insurance purchased. This term insurance allows you to increase your coverage up to eight times your annual salary (less $1000), up to a maximum of $1.5 million. Term insurance pays your designated beneficiary in the event of your death. An employee must be enrolled in Basic Life Insurance in order to enroll in Optional Life Insurance. It is not an investment policy; it has no cash value. New state employees may enroll in Optional Life Insurance up to 8 times salary without the need for any medical review. Current employees can apply to increase Optional Life coverage any time during the year, however, evidence of insurability for insurance approval must be provided to enter the Plan. Visit the Group Insurance Commission Life Insurances for more specific information on Basic and Optional Life Insurance.
Long Term Disability
The GIC’s Long Term Disability (LTD) program is insured by MetLife. Employees are eligible to begin coverage 60 days from the first full month of employment. Current employees can apply for LTD coverage during annual (first-time eligible) enrollment, or any time during the year, however evidence of insurability for insurance approval must be provided to enter the Plan. LTD is an income replacement program in the event you become disabled and are unable to perform the material and substantial duties of your job. If an employee is determined disabled by the provider and unable to work for longer than 90 days, the employee will receive 50% of his/her tax-free monthly salary up to a maximum monthly benefit. Premiums are based on age/current salary and as both increase, premiums are adjusted. For more detailed information on long-term Disability, please visit Group Insurance Commission, select State Insurance Benefits, then Long term Disability (LTD) Overview.
Dental Insurance and VisionAccess EyeCare Program
Dental Insurance & Vision Plans are available to benefitted Non-Unit Professionals, their spouse, and dependent(s) as separate benefits from your health insurance. Dental & Vision coverage begins 60 days from the first full month of employment. If not elected when hired, open enrollment takes place in November/December for January 1st coverage.
The carrier is MetLife. The MetLife Dental Policy Number is 105385. The MetLife VisionAccess Program Code is MET2020. Dental benefits are managed for the Department of Higher Education's Non-Unit employees by Health Plans, Inc. For more detailed information on dental coverage, please visit https://www.healthplansinc.com or the MetLife website:
View the Dental Plan Summary and MetLife VisionAccess Plan.