Massachusetts GIC announces dental and vision plan changes with new carriers and enhanced benefits

The Massachusetts Group Insurance Commission (GIC) held its first public information session for 2025 on January 29, 2025, focusing on the structure and updates of health benefits for state employees and retirees. The session aimed to clarify how benefits are funded and to inform members about upcoming changes to their insurance plans.

The meeting began with an overview of the GIC's funding model, emphasizing that the Commonwealth of Massachusetts covers a significant portion of benefits through the state budget. Members also contribute to their premiums, typically deducted from their paychecks or pensions. Notably, the GIC operates as a self-insured entity, meaning that the state assumes the insurance risk rather than external insurance companies. This structure implies that if healthcare usage exceeds expectations, the state bears the additional costs, while insurance companies receive a fixed fee based on enrollment.

Participants were encouraged to submit questions throughout the presentation, with a reminder to consult the FAQ document for general inquiries. The session then transitioned to updates regarding insurance providers. There were no significant changes to the healthcare plans or pharmacy benefits, which will continue to be managed by CVS Caremark for active employees and through the SilverScript program for Medicare members. However, members were advised to review their benefit guides during the annual enrollment period to ensure their plans meet their needs, especially as premiums are expected to rise substantially.

A key highlight of the meeting was the announcement of changes to dental and vision plans. The GIC will transition from MetLife and Davis Vision to Altus Dental and VSP, respectively. This change is anticipated to lower premiums and increase annual maximums for dental coverage, allowing for greater reimbursement for costly procedures. Additionally, the vision plan will now cover annual exams for active participants, a shift from the previous biennial coverage.

The session concluded with a discussion on how premiums are determined within the self-funded model of the GIC, emphasizing the importance of member engagement during the enrollment process. Overall, the meeting provided essential insights into the GIC's operations and upcoming changes, ensuring that members are well-informed as they prepare for the new fiscal year.