GIC Approves 2020 Plan Design

GIC Approves 2020 Plan Design

No Medicare Benefit Changes

FEBRUARY 7, 2019: The 17-member Group Insurance Commission (GIC) met this morning to set insurance plan design for Fiscal Year 2020. Plan design encompasses insurance benefits, as well as copayments and deductibles. Insurance premiums are scheduled to be approved on February 28.

For the coming fiscal year, which begins on July 1, there will be no benefit or copayment changes impacting Medicare supplement plans. GIC Medicare enrollees do not pay annual deductibles.

Non-Medicare plans will see a change in the copayment for Ambulatory Surgical Care. Beginning July 1, 2019 there will be a two-tiered copayment structure. The copayment for Ambulatory Surgical Care performed in a hospital will remain at $250, while the copayment at a standalone medical facility is $150. As we report in the coming March edition of the Voice, there are often stark differences in price depending upon where the procedure is performed. Hospital settings are often 2-3X as expensive, despite the fact that the same doctors often perform the procedure. 

Mass Retirees continues to object to any further cost shifting by the GIC. Instead we’ve called on them to find ways to lower the cost of medical care. Using a two-tiered copayment system is one way to help lower costs, while maintaining options and choice,” says Association Legislative Director Shawn Duhamel, who attended Thursday’s GIC meeting along with General Counsel Bill Rehrey. “For many procedures it makes sense to choose the lower cost facility over a high-priced teaching hospital, which is often located in Boston. We are at a point where we have to be mindful of cost when it comes to healthcare. Every situation is different and retirees must do what they and their doctor believe is best for them.”

For the second consecutive year, the GIC has chosen not to increase prescription drug copayments.

While premium contribution rates will be set on February 28, the GIC did offer a glimpse at costs for FY20. The anticipated average premium increase across all GIC plans is 3.3%. However, individual plan rates will vary depending on the plan. Across Massachusetts private sector costs are expected to increase 6% on average in 2019.