GIC ELIMINATES TUFTS, HARVARD PILGRIM, FALLONSenior products will be available from UniCare and Tufts Health Plan.
The Group Insurance Commission (GIC) held a meeting Thursday morning to discuss plan offering for FY19. There was a vote to eliminate Harvard Pilgrim Health Care, Tufts Health Plan, and Fallon Health from their active employee plan offerings effective 7/1/2018. The only carriers available to active members will be UniCare, Neighborhood Health Plan, and Health New England. Geographically, there will be some municipalities that will only have UniCare available.
Senior products will be available from UniCare and Tufts Health Plan. All Pharmacy benefits will be uniformly offered through Express Scripts for all non-Medicare plans.
The vote passed by:
YES – 8
NO – 5
ABSTAIN – 2
Please see the email (below) from Robert Herman, Executive Director of the GIC regarding this meeting.
Dear GIC Member,
Today, the Group Insurance Commission (GIC) voted to approve recommendations stemming from a year-long procurement process, which has been widely socialized and shared with our Commission throughout. This will result in changes to our current health plan vendors, effective July 1, 2018.
The GIC is making these changes to provide the greatest benefits to the GIC and its members. Through this decision, we will move from a patchwork of carriers offering similar benefits and services to a model that provides meaningful choice, sustainability and simplification for each of you. More specifically, we will transition from 6 carriers to 3 for active employees and non-Medicare retirees (Commercial enrollees), from 5 carriers to 2 for Medicare enrollees and from 6 carriers to 1 for our Pool 2 enrollees.
Please note: members will not experience a loss in health care coverage and the GIC’s goal is for members to keep their current physicians and hospitals with comparable coverage and benefits after plan migration.
What’s Changing and When?
Effective July 1, 2018, the GIC will offer health plans from the following vendors:
- Commercial: Unicare, Neighborhood Health Plan and Health New England
- Medicare: Unicare, Tufts
- Pool 2 Offering: Unicare
- Carriers being eliminated: Harvard Pilgrim, Fallon, Tufts (Commercial only)
We are also planning to uniformly carve-out pharmacy benefits to ExpressScripts for Commercial and Pool 2 members, and will retain CVS/SilverScript for Medicare enrollees.
As a result of this change, nearly half of members will be able to retain their current health plan carrier. GIC members from impacted health plans will automatically migrate into new health plans, and will have the opportunity to select a new plan during annual enrollment, if desired.
Additional Opportunities to be Heard
Your voice is important and the GIC wants to ensure that you have the opportunity to share your input about future plan and benefit designs.
Starting tomorrow, Friday, January 19th in Worcester, the GIC will embark on a series of public hearings across the state. More details on the times and locations of these public hearings can be found below. As a reminder, this series is in addition to the Listening Tours and member survey that were conducted in the fall to solicit public input before any decisions were made.
Final benefit decisions will be voted on by the Commission on February 1st and rates for final plans will be decided on February 22nd.
Group Insurance Commission