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									                       Group Insurance Commission (GIC)
                             Frequently Asked Questions
 Q:      Will I be covered by my current Town-sponsored health insurance until July 1st?
        A: Yes.

              Q: I’m a town employee. Am I eligible for GIC Health Insurance?
       A:     All full-time employees (34+ hrs/week) and part-time employees who work a
               minimum of 18.75 hrs. per week are eligible for insurance benefits.

Q: I’m not currently enrolled in a Town-sponsored Health Plan. Am I eligible for GIC?
 A: Yes. If you’re eligible for insurance benefits, you can enroll in a GIC health plan.

          Q: There are 9 plans offered by GIC – which one should I choose?
 A: Each employee should judge for themselves which plan best suits their needs. Some
plans require members to choose a primary care physician, some require referrals to other
providers, and some require you select from providers within a pre-defined network. Still
other plans require none of the above. For more information on the plans offered by GIC,
                                 visit www.mass.gov/gic.

         Q: What’s the difference between an HMO, PPO and Indemnity Plan?
A: An HMO (Health Maintenance Organization) is a health plan that provides coverage
 for treatment by a network of doctors, hospitals and other health care providers within a
  certain geographic area. HMOs do not offer out-of-network benefits. A PPO (Preferred
Provider Organization) is a health insurance plan that offers coverage by network doctors,
  hospitals, and other health care providers, but also provides a lower level of benefits for
   treatment by out-of-network providers. A PPO plan does not require the selection of a
  Primary Care Physician (PCP). An Indemnity Plan, sometimes referred to as a ‘Fee for
  Service’ Plan, is a health plan that typically places no restrictions on which providers a
                          member may visit for healthcare services.

  Q:        GIC also offers Vision, Dental and Life Insurance. Am I eligible for any of these
                                             plans?
  A:        No. Town employees are only being offered Health Insurance coverage with GIC.

                  Q: How soon do I need to choose a GIC Health Plan?
A: The GIC Enrollment Fair is Tuesday, April 28th at the Swampscott High School
Gymnasium. Open enrollment is April 13, 2009 – May 15, 2009. Subscribers and new
enrollees must sign up for a GIC health plan by May 15, 2009. The executives of GIC have
given the Town a strict timeline to follow which allows for very little leeway in meeting
enrollment deadlines.
        Q: Will I have the opportunity to ask questions at the Enrollment Fair?
A: Yes. A team of GIC representatives will be available to educate and enroll all eligible
employees. GIC recommends you make your Health Plan decision prior to the fair and use
  the resources available to reinforce that decision. In other words, do your homework -
              don’t wait until the day of the fair to start reviewing the plans.

                   The Enrollment Fair will be divided into sections.
 GIC reps will show a PowerPoint Presentation continuously throughout the day to assist
                    employees with the transition to GIC insurance.
Representatives from each health plan, plus United Behavioral Health (UBH) and Express
                      Scripts, will be on hand to answer questions.
     Treasurer’s Office staff will be on hand to answer any questions you may have.
GIC Enrollment Specialists will be set up with laptop computers to electronically enroll all
                                    eligible employees.

                      Q: What should I bring to the Enrollment Fair?
      A: If you plan to enroll that day in an individual plan you need only bring your
 enrollment information. If you plan to enroll a spouse or dependent(s) it is mandatory that
     you submit, in advance of your enrollment, to the Treasurer’s Office a copy of your
 marriage license and each child’s birth certificate. The copy doesn’t need to be certified; a
  simple photocopy will be fine. Please note: even if your spouse and children are currently
    enrolled in your Town-sponsored health insurance plan (HMO Blue, etc.), you are still
required to provide a copy of a marriage license and birth certificate(s). This is a GIC rule.

  Q:    Where can I get a copy of my marriage license (birth certificate, divorce decree,
                                             etc.)?
A: Marriage Certificates are on file in the town where you filed your intentions, not the
 town where you were married. Birth certificates are on file in the town where your child
  was born, and the town the parents were living in at the time of the child’s birth. Both
certificates are available online for a fee. For more information, call the Registry of Vital
                          Records and Statistics at (617) 740-2600.

  Q:    How can I get vital records from Swampscott?
A:     If you need a vital record from the Swampscott Town Clerk’s office, you should
contact the Treasurer’s Office at 781-596-8852 for a form. This form will allow the
employee/retiree to request their records to be turned over directly to the Treasurer’s
Office at no charge. If the employee/retiree would like a certified copy for their records, the
charge will be $5.00 per item.


Q:    My son or daughter is 19 yrs. (or older) and attends school full time. Do I need to fill
                              out any additional paperwork?
  A: Yes. Although you won’t need to fill out a Student Affidavit Form (as is required
  with Blue Cross) you will need to fill out a ‘Dependent Age 19 and Over Application for
    Coverage’ form. Unless this form is completed and submitted with your enrollment
information, a dependent’s coverage will end at the end of the month in which he/she turns
               19 yrs. The GIC will determine eligibility and effective dates.

Q:     My son or daughter is 19 yrs. (or older) and not a full time student. Is he/she eligible
                             for coverage under my family plan?
A: Yes. New laws allow a dependent to remain on your Health Insurance plan up to age
 26. Please note: this coverage, although included in your health insurance premium, is not
  free. You will be subject to imputed income on the full cost individual premium for the
  health plan in which you are enrolled, for each non-IRS dependent covered under your
policy. Click here for the definition of ‘imputed income’ and a chart with the taxable dollar
         figure for each plan. The GIC will determine eligibility and effective dates.

    Q: What portion of the monthly premium is paid by the Town for each plan?
   A:    For all HMOs and PPOs the split is 62.5/37.5. The town pays 62.5% and the
employee pays the remaining 37.5%. For Indemnity Plans the split is 60/40. The town pays
                    60% and the employee pays the remaining 40%.

 Q:    I’ve decided to enroll in my spouse’s plan instead of going to GIC. Will I be able to
                        enroll in a GIC health plan at a future date?
  A:    Yes. GIC has an open enrollment period every April with a July 1st effective date.

       Q: If I enroll in a GIC plan now, can I change my mind and switch plans?
A:     Yes. You will have the opportunity to change your plan during the open enrollment
                 period in April. The change would be effective July 1st.

Q:    I’m a full time employee and eligible for health insurance. If I don’t enroll in a GIC
                   plan will I be put into any particular plan by default?
A: No. If you don’t enroll in a GIC health plan, you’re free to seek coverage elsewhere.
 If you currently have health insurance through one of the town-sponsored plans (Blue
                      Cross), that coverage will end on June 30, 2008
                                               .
 Q: I have Life/Dental/Disability Insurance through the Town. Will this change too?
 A: No, the Life, Dental and Short Term Disability Plans offered by the Town are not
                    affected by switching to GIC Healthcare Insurance.

     Q: Will I receive the enrollment packet before the April 28th Enrollment Fair?
    A: Yes. The Treasurer’s Office will be putting together hundreds of enrollment
packages and every eligible employee/retiree will receive one. We expect the packages to be
 delivered and available for distribution/pickup during the first full week of April. If you
 have made other arrangements for your health insurance, and will not be enrolling with
 GIC, we ask that you let us know before 04/24/09 so we can remove your name from our
                                 Enrollment Fair checklist.

                   Q: Where can I find more information about GIC?
                    A: Visit the GIC website at www.mass.gov/gic/
                                   What about Medicare….

      Q:    I’m 65 yrs. (or over), RETIRED, and eligible for Medicare, do I have to sign up
                                        for Medicare?
      A: Yes. The health plans GIC offers to retirees require you to enroll in both Part A
      and Part B. If you are age 65 or over, call or visit a local Social Security Office for
             confirmation of Social Security and Medicare benefit eligibility.

         Q: I’m 65 yrs. (or over), NOT retired, and eligible for Medicare, do I enroll
also?     A: If you are eligible and you continue working after age 65, you should enroll
     in Medicare Part A. You should not enroll in Medicare Part B until you retire.

           Q:   I live in Florida and cannot attend the Enrollment Fair. How will I enroll?
           A:    Retirees who live out-of-state will be handled on a case by case basis. The
                      enrollment process will be handled through the mail.

     Q: I live in North Carolina. Will my doctor be included in any of the plans?
      A: Yes. You have the option of choosing an Indemnity Plan which allows you to
choose any provider in any state. Keep in mind, Indemnity Plans are a bit more expensive
  than the PPO and HMO plans, but they offer more flexibility in choosing a healthcare
                                        provider.


             Q: I’ve already enrolled with Medicare. Will I need to show proof?
    A: Yes. You will need to bring a letter from Medicare stating that you have already
 enrolled in Medicare, and in which Parts (A, B, etc.) provide copy of your Medicare cost
                                    showing part B.

             Q: Where can I find more information about GIC and Medicare?
      A: GIC’s Medicare Guideline and Medicare FAQ may provide answers to your
questions. Some handouts from the GIC website are also available in the Personnel Office.

 Q:     I’ve read all the information I can find on GIC and the available health plans, but I
                             still have questions. Who should I call?
  A: If your questions are about a specific health plan (participating doctors, networks,
etc.) then you may wish to contact the plan directly. The GIC website provides a synopsis of
   each plan’s benefits, as well as a contact number. If your questions are specific to GIC
   (state laws, deadlines, etc.) then you may wish to call GIC’s Public Information Line at
(617) 727-2310 extension #1. The Town’s Treasurer’s Office may be able to help also. Keep
in mind we have many unanswered questions, but we’ll do our best to provide you with the
                                    most up-to-date information.

                              Treasurer’s Office – 781-596-8852

								
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