GIC says dental, vision vendors will change and rolls out benefit enhancements as premiums rise

Group Insurance Commission officials announced a change in dental and vision vendors for fiscal 2026, several benefit enhancements and other plan design updates, and cautioned that health insurance premiums will be significantly higher next year.

The changes matter because the GIC covers roughly 455,000 members, including about 110,000 retirees, and manages a roughly $3,000,000,000 annual budget on behalf of the Commonwealth and participating public employers. Those funding dynamics and the GIC’s self‑insured structure mean cost shifts affect the state budget and employer contributions as well as members’ paycheck or pension deductions.

GIC presenter Matt, speaking early in the session, framed the commission’s goals as balancing “high quality and affordable benefits.” He said affordability is “getting harder and harder as healthcare costs that underlie the premiums continue to rise.”

Cameron McBean, the GIC’s director of vendor management, announced the result of the commission’s recent procurement for dental and vision coverage. “We’re going to be moving back to Altus Dental,” McBean said, and Altus will provide vision coverage in partnership with VSP. McBean said the procurement produced “favorable terms” that allowed the GIC to raise the annual maximums across the three GIC‑sponsored dental plans. According to the presentation, the lifetime/annual individual dental maximum that had been $1,500 will increase to $1,750 effective July 1.

McBean described additional vision improvements: active employees on the new Altus/VSP plan will be eligible for an eye exam annually rather than once every two years, and the retiree vision discount will be available at point of sale rather than through a prepaid voucher.

On medical plan design, McBean said the GIC will add digital musculoskeletal care through an app called InchHealth and will harmonize fertility benefits so plan choice no longer determines covered services. He also said the commission plans to remove limits on nutritional counseling to comply with the mental health parity law.

McBean attributed upward pressure on premiums to broad market forces, including provider price increases and expensive new drug demand such as the GLP‑1 agents discussed nationally. He said preliminary calculations show the GIC will see “higher increases than we have historically seen” and that final rates will be presented and voted by the commission in February, becoming effective July 1.

The presentation also summarized recent legislative and budget changes that affect benefits. McBean said the PACT Act passed late in the legislative session will increase GIC spend and reduce cost shares for a subset of common generic medications; he said, “No new drugs will become available to GIC members as a result of this law, but cost shares will go down.” He also noted the legislature increased the basic life insurance benefit for most GIC members from $5,000 to $10,000; the change carries a small premium share for members.

The commission emphasized that most insurer relationships are unchanged for the upcoming year: CVS Caremark will continue to administer pharmacy benefits for active plans and CVS SilverScript for Medicare plans, and the GIC will continue to offer its existing network and limited‑network medical plans through vendors including Harvard Pilgrim, Tufts Health Plan (Medicare Preferred), WellPoint and Health New England.

Officials told members to review benefit decision guides and the member portal during annual enrollment since plan premiums and available enhancements may make different options preferable for some enrollees.

While presenters outlined several enhancements and administrative decisions, they repeatedly noted premium figures and final rates remain subject to actuarial review; the GIC will present final premiums to the commission in February.