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Benefits Open Enrollment

Enrollment forms are due to the UMass Lowell Benefits Office no later than Wednesday, May 3, 2017 if making benefits changes. Please call the Benefits Office at 978-934-4100 or email us at Benefits@uml.edu if you have any questions.

2017 Annual Enrollment Begins April 5 and Ends MAY 3

Changes made take effect July 1, 2017  

Annual enrollment time is here, giving you the opportunity to review your benefit options and choose a new health plan or make other benefit changes if you wish. Take action during Annual Enrollment!  Do your homework, even if you think you want to stay in the same health plan. Take this opportunity to think about what you and your family need in the way of health care and other benefits.

During annual enrollment, if eligible, you may:

Be sure to read your GIC Benefit Decision Guide for benefit and rate changes effective July 1, 2017

For more information, check out Plan Year 2017-2018 Annual Open Enrollment News and 2017 health fair schedule.

Please note important BENEFIT CHANGES that will take effect JULY 1, 2017


Health Plan Changes

New Prescription Drug Fiscal Year Deductible
There will be a new separate prescription drug deductible of $100 individual/$200 family for all health plans except Fallon Health Direct and Select. Oral chemotherapy and preventive care medications covered under the Affordable Care Act will not be subject to the deductible. 

Fiscal Year Medical Deductible
The fiscal year deductible will increase to $500 individual/$1,000 family (regardless of family size). For the Fallon Health Direct and Select plans, the deductible will increase to $550 individual/$1,100 family. 

Health Plans Closed to New Members
Due to concerns about significant premium increases and spending beyond those premium rates, Fallon Health Select Care, Harvard Pilgrim Independence Plan, and Tufts Health Plan Navigator will be closed to new members:
Existing members can stay in or leave these plans and can change their coverage (e.g., individual to family) within 60 days of a qualifying event; however,
New groups or new employees joining the GIC cannot enroll in these plans;
Individuals who are picking up GIC health insurance coverage during Annual Enrollment or within 60 days of a qualifying event cannot enroll in these plans; and
Existing GIC members currently enrolled in other health plans cannot switch into these plans. 

Medication-Assisted Treatment 
There will no longer be any copayments or prior authorization for Medication-assisted Treatment for opioid use disorder (generic buprenorphine-naloxone, naloxone, and naltrexone products). These drugs will also not be subject to the prescription drug deductible.

Harvard Pilgrim Independence and Primary Choice Plans 
The prescription drug formulary for these plans will change to a closed formulary similar to the other plans. This means certain prescription drugs will be excluded from coverage, but will have alternatives available that are more cost effective. 
Physician office visit and hospital tiering will change to one based on provider group value instead of individual performance. This could affect your copays. Contact the plan to see each of your provider’s tiers for the office location you visit. Also, contact the plan to see which tier your hospital is in. 

Harvard Pilgrim Independence Plan 
Will implement Primary Care Provider (PCP) tiering based on provider group value: $10 Tier 1/$20 Tier 2/$40 Tier 3. Contact the plan to find out which tier your PCP is in. 
The outpatient behavioral health/substance use disorder office visit copay will decrease to $10 per visit. 
The out-of-network deductible will increase to $500 per individual and $1,000 per family. 

Tufts Health Plan Navigator and Spirit 
Physician office visit and hospital tiering will change to one based on provider group value instead of individual performance. This could affect your copays. Contact the plan to see each of your provider’s tiers for the office location you visit. Also, contact the plan to see which tier your hospital is in. 

Tufts Health Plan Navigator 
Will implement Primary Care Provider (PCP) tiering based on provider group value: $10 Tier 1/$20 Tier 2/$40 Tier 3. Contact the plan to find out which tier your PCP is in. 
vThe outpatient behavioral health/substance use disorder office visit copay will decrease to $10 per visit. 
The out-of-network deductible will increase to $500 per individual and $1,000 per family. 

Unicare State Indemnity Plan/Basic and Community Choice 
The telehealth benefit already available to UniCare PLUS members will be expanded to these two plans: $15 copay/telehealth visit. 

Unicare State Indemnity Plan/Plus 
The out-of-network deductible will increase to $500 per individual and $1,000 per family.


Other GIC Benefit Changes

Long Term Disability 
The GIC awarded a new contract to Unum to continue as the Long Term Disability carrier. The rates will go down by approximately nine percent, depending on your age. Now is a good time to consider applying.  

Pre-Tax Flexible Spending Accounts 
The Health Care Spending Account maximum will increase to $2,600. 
In keeping with state statute, eligibility for the Dependent Care Assistance Program is changing. To participate, you must be eligible for GIC health insurance benefits.