All 6 Health Plans To Continue

FEBRUARY 19, 2013: The state’s Group Insurance Commission (GIC) voted to retain all six of its current health insurance providers. While the bids have been accepted by the GIC, the specifics of the contract are now being negotiated in advance of the GIC’s March meeting.

Retirees and survivors insured under the GIC’s Optional Medicare Extension (OME) plan are very happy to see that UniCare will continue as the plan’s provider. UniCare also carries the GIC’s indemnity plan, which is widely popular for non-Medicare retirees.

Tufts, Harvard Pilgrim, Fallon, Neighborhood Health Plan and Health New England are expected to be resigned to new three-year contracts with the GIC, with the option of two one-year extensions. By law, the GIC must rebid its contracts every five years.

Adding to the significance of this year’s GIC bidding process is the state’s new healthcare cost containment law, Chapter 224. Passed last summer, Chapter 224 instructs the GIC, among other insurance providers, to implement certain cost containment measures within its health plans beginning this July 1. Our Association, as well as the GIC, will keep retirees and survivors informed as to the changes that may come about as a result of Chapter 224.

The Association will also be on hand for the GIC’s March 6 meeting, at which time the rates for FY14 will be announced. At its meeting on February 15, GIC Executive Director Dolores Mitchell stated that no significant premium increases are predicted at this time.

One major change coming to the GIC is the departure of United Behavioral Health (UBH) as the GIC’s carve-out behavioral health provider. Boston-based Beacon Health Strategies has been awarded a new three-year contract in place of UBH.

Also, this year’s procurement process did not include the GIC’s pharmacy benefits program. CVS Caremark is now in its third year as the GIC’s PBM.

The following is a summary of actions taken at the February 15, 2013 meeting:

  • No change whatsoever in Health Insurers. Status quo maintained with UniCare, Tufts, Harvard, Fallon Health NE & Neighborhood.
  • All 6 agreed to meet GIC annual budget targets beginning in Fiscal 2014 through Fiscal 2018.
  • GIC's budget targets "very aggressive" at just 2% over Baseline (Fiscal 2013) in Fiscal 2014, 2% in Fiscal '15, 0 in Fiscal 2016 thru '18.
  • GIC Commissioners authorized staff to enter into contract negotiations with the six health plans. Contracts & Premiums to be approved at 3/6 Meeting.
  • Major change in Behavioral Health: United Behavioral to be replaced by Beacon Health Strategies, a Boston-based company that currently has some 700,000 in its network. Mitchell emphasized that the GIC will do all it can to ensure a smooth transition and no disruption of ongoing treatment. (Beacon Health will work on having providers, who aren't yet in their network, to sign up.
  • No Major Plan Design Changes: Will not mandate Primary Care Provider (PCP) for plans that currently don't require them. GIC plans (i.e., OME, Indemnity). Considered changing Deductible from Fiscal to Calendar Year, but will stay put w/ Fiscal Year Deductible.