The Group Insurance Commission (GIC) has new premium rates for FY2025. The employee contribution rates will remain at 20% for the HMO, PPO & POS plans. Indemnity plans will also hold the current employee contribution rate of 25%.
The GIC’s main changes for FY2025 are in the rate increases ranging from 5-11% depending on the plan and Unicare’s name change to Wellpoint as of July 1, 2025.
Please be sure to visit the Group Insurance Commission’s (GIC) web page at mass.gov/gic for complete information regarding plan changes.
Also, take this opportunity annually to review the GIC Benefit Decision Guide for further understanding of the details of your health plan. Reference the Summary of Benefits for a comparison of all health plans offered.
IMPORTANT Information For Those Declining Health Insurance
If you will not be enrolled in the City’s Health Insurance in FY2025, you will be required to complete the Health Insurance Responsibility Disclosure (HIRD) form and return it to Personnel by Wednesday, May 1, 2024. Note that this is an annual requirement.
Forms and Information
- GIC Benefit Decision Guide
- Health Insurance Responsibility Disclosure (HIRD) form
- Enroll in a GIC Plan (New Members Only)
- Change or Cancel Your GIC Plan (Current Members Only)
- Health Plan Rates for All Members
- Premium Assistance Under Medicaid and the Children's Program (CHIP) Notice
- FY2024 GIC Health Plan Rates
- FY2024 Dental, Life & Vision Insurance Rates
Opt Out
Your dental insurance coverage will continue to be provided by Cigna with Low and High Plan options. The dental benefit allows you to purchase voluntary dental coverage and is 100% employee contributory. The dental rates for FY2025 have increased by 4%. Benefit allowances will remain the same.
The City of Somerville’s dental plans are administered by Cigna. Your dental program combines two of Cigna’s national dental networks – Cigna DPPO Advantage and Cigna DPPO, called Total Cigna DPPO. You may receive dental care from any dentist you choose, regardless of whether he or she participates in either the Cigna DPPO Advantage or Cigna DPPO network; however, you will generally receive the maximum benefit at the lowest cost when you visit a dentist who is a member of the Total Cigna DPPO Advantage network. These dentists have agreed to charge Total Cigna DPPO participants discounted fees for their services, which means you will normally pay less when you visit a participating dentist. Additionally, when you seek care from either a Cigna DPPO Advantage or Cigna DPPO network dentist there are no claim forms to complete.
Forms and Information
- Benefits Summary (High Option)
- Benefits Summary (Low Option)
- Enrollment Form
- Active Employee Dental Plan Rates
- Retiree Dental Plan Rates
Cigna Dental Plan Information
- Dental Oral Health Integration Program
- Total DPPO with Advantage
- DPPO How to Find a Dentist
- DPPO Customer FAQ
- Requesting Cigna Digital Card
More information about Dental Plans
Plan Summary
The City of Somerville provides you with access to a low plan and a high plan. Both provide access to preventive and basic restorative services; however, the high plan is the only plan that provides coverage for major restorative services and orthodontia for dependents under the age of 19. Both plans pay a portion of the cost of covered dental services based on the service that you receive. They offer the same level of benefits for in- and out-of-network services, but in-network dentists offer discounted fees, so your out-of-pocket expenses are usually less when you visit an in-network dentist. Other than for preventive care (Type I services), the both plans require you to satisfy an annual deductible before benefits are paid.
The low plan has a calendar year maximum benefit on all covered services of $750, and the high plan has a calendar year maximum benefit on all covered services of $1,750 for each covered member; however, individuals enrolled in the high plan will have the opportunity to increase the level of their annual maximum each year simply by utilizing their preventive benefits (i.e. check-up, cleaning, etc.). If an individual goes for at least one check-up or preventive cleaning during the year, their individual plan maximum will increase the following year by a $100. In addition, the high plan covers orthodontic services for dependents up to age 19. These services and supplies are covered at 50% and have a separate lifetime maximum of $2,000.
If you choose to see a provider outside of the Total Cigna DPPO, both the Low and High plans will pay benefits up to the maximum and allowable charge. You may also be required to pay your non-Total Cigna DPPO dentist directly for the service and then file a claim for reimbursement.
Comparison of Services
|
Low Plan |
High Plan |
|
Type I Diagnostic & Preventative Care
|
Type I Diagnostic & Preventative Care
|
|
Type II-Basic Restorative Care
|
Type II-Basic Restorative Care
|
|
— |
Type III-Major Restorative Care
|
|
— |
Ortho Care
|
|
Calendar Year Maximum: The calendar year maximum per covered individual for Type I and Type II services combined is $750. Once you or a covered family member has incurred a total of this amount in one calendar year, you will be responsible for the cost of all dental services for that individual for the remainder of that calendar year. |
Calendar Year Maximum: The calendar year maximum per covered individual for Type I, Type II and Type III services combined is $1,750; however, this amount will increase by $100 each year as long as an individual member has received a check-up or cleaning during the course of the calendar year. Once you or a covered family member has incurred a total of this amount in one calendar year, you will be responsible for the cost of all dental services for that individual for the remainder of that calendar year. |
Have a question about the plans?
If you have questions about your Cigna dental plans, please:
- Call the Cigna Customer Service Department at 800.Cigna24 (800.244.6224)
- Representatives are available 24-hours a day, seven days week and 365 days a year
- Visit the Cigna website to look up participating dentists or, if already enrolled, set-up and check your personal mycigna.com account for specific plan details, review the status of claim, order an ID card, look up providers, and more.
Your vision insurance benefits will continue to be provided by Vision Service Plan. The vision benefit allows you to purchase voluntary vision coverage at a relatively low cost and is 100% employee contributory. The rates remain fixed at $5.39 monthly for an individual plan and $14.90 monthly for a family plan. Benefit allowances will remain the same. Note: Currently, for those employees who are enrolled in the GIC Health Insurance plans, you are offered one (1) eye exam every twenty-four (24) months and access to discounts on frames and lenses.
Enrolled members can choose to see any doctor of their choice; however, benefits are maximized when received through a VSP participating doctor. Members can choose from one of 30,000 participating doctors nationwide. VSP Doctors are located in retail, neighborhood, medical and professional settings.
Vision Service Plan Forms
More Information about the Vision Plan
Copays (apply in and out of network) |
|
| WellVision Exam | $10 copay |
| Materials | $25 copay |
Plan Frequencies |
|
| Exam | Once every plan year* |
| Lenses | Once every plan year* |
| Frame | Once every other plan year* |
| *Plan year begins July 1 | |
Reimbursement |
||
| Services | Benefits with VSP Doctor | Out of Network Reimbursement |
| WellVision Exam: | Covered in full after copay | Reimbursed up to $45 |
| Frame: | -Covered up to $150 retail allowance-20% off any amount above the retail allowance | Reimbursed up to $70 |
| Lenses:Single VisionLined BifocalLined TrifocalLenticular | Covered in full after copayCovered in full after copayCovered in full after copayCovered in full after copay | Reimbursed up to $30Reimbursed up to $50Reimbursed up to $65Reimbursed up to $100 |
| Contact Lenses(instead of glasses) | -$150 allowance for contacts, copay does not apply-Contact lens exam (fitting & eval) covered after $60 max copay | Reimbursed up to $105 |
Additional Savings
- Lens enhancements are covered after a copay, saving members an average of 20-25%.
- 20% savings on additional glasses or sunglasses, including lens enhancements, from any VSP provider within 12 months of your last eye exam
- Average 15% off the regular price, or 5% off the promotional price of laser vision correction services through VSP contracted laser centers
Member Exclusive Offers: Exclusive special offers from VSP and leading industry brands for VSP members only. Visit vsp.com/special offers
Using your benefit is easy…
- Register at vsp.com.
- Once your plan is effective, review your benefit-information.
- Find an eye care provider who’s right for you.
- To find a VSP provider, visit vsp.com or call 800-877.7195.
- At your appointment, tell them you have VSP.
- There’s no ID card necessary. If you’d like a card as a reference, you can print one on vsp.com.
Enrollment
If you wish to enroll in the voluntary vision benefit through VSP, please complete the VSP Enrollment Form and return it to Personnel for processing within the applicable time frame.
Group Life & Supplemental Insurance
Group and Voluntary Term Life Insurance
Your life insurance benefits will continue with our current provider, Boston Mutual.
Group Life Insurance
Your Group Life plan design remains the same for FY2025. The basic group life employee contribution will remain $5.53 a month. Your Group Life coverage is 50% employee contributory. New enrollments will require an enrollment form as well as completed Evidence of Insurability and HIPAA forms to be submitted for actuarial approval by Boston Mutual.
Voluntary Term Life
Voluntary Term Life may be increased in increments of $10,000. New enrollments as well as enrollment changes will require an enrollment form as well as completed Evidence of Insurability and HIPAA forms to be submitted for actuarial approval by Boston Mutual.
Learn more about Voluntary Life
Boston Mutual offers active employees working a minimum of 20 per week $5,000 of Basic Life and Accidental Death & Dismemberment (AD&D) Insurance. Upon retirement, coverage continues at $5,000.
In addition to offering Basic Life and AD&D Insurance. Boston Mutual offers active employees the opportunity to insure their spouse and dependent children. You must be enrolled in the Basic Life and AD&D program to enroll in the Voluntary Term Life program.
You have the flexibility to choose coverage for yourself in units of $10,000 to a maximum of $500,000. However, the maximum coverage amount you may elect cannot exceed seven times your base annual salary.
You may insure your spouse in units of $5,000 to a maximum of $100,000, not to exceed 50% of your coverage amount.
You may insure your dependent children for Life Insurance only. Coverage amounts are as follows:
- 14 days to 6 months: $500
- 6 months to 1 year: $500
- 1 year to 19 years*: $5,000
- (*Age 25 for full-time students)
Please refer to the Basic Life Summary for further details on the Group Life Policy and the Voluntary Term Life Summary for further details on the Additional Life Policy.
Medical Questions
If you and your eligible dependents enroll within the initial eligibility period as defined by the policy, you and your spouse may purchase a specific amount of insurance on a guaranteed basis. No medical questions will be asked for coverage at or under the Guarantee Issue Amount.
Enrollment
If you wish to enroll in the Group/Voluntary life insurance through Boston Mutual, please complete the Boston Mutual enrollment form and return it to Personnel for processing within the applicable time frame.
| Age | Employee | Spouse |
| Under 60 Years | $150,000 | $30,000 |
| 60-69 Years | $80,000 | $20,000 |
| 70+ Years | $10,000 | Not Eligible |
Voluntary Insurance & Benefits
At this time, you can also review voluntary insurance coverage that is available to you through Colonial Life Insurance. Employees of the City of Somerville have the option to apply for supplemental insurance on a voluntary basis. This benefit offers the convenience of premium payment through payroll deduction; portability: the ability to take coverage with you if you change jobs or retires; benefit checks are paid directly to you; and flexible coverage: you choose the coverage amount and type that meets your individual needs.
Please find below a list of the coverages available:
Disability Insurance: Replaces a portion of you or your spouse’s income to help make ends meet if you become disabled from a covered accident or covered sickness.
Accident Insurance: Helps to offset the unexpected medical expenses, such as emergency room fees, deductibles, and copayments, that can result from a fracture, dislocation or other covered accidental injury.
Cancer Insurance: Helps to offset the out-of-pocket medical and indirect, non-medical expenses related to cancer that most medical plans don’t cover. This coverage also provides a benefit for specified cancer-screening tests.
Critical Illness Insurance: Complements your major medical coverage by providing a lump-sum benefit that you can use to pay the direct and indirect costs related to a covered critical illness, which can often be expensive and lengthy.
Hospital Confinement Insurance: Provides a lump-sum benefit for a covered hospital confinement to help offset the gaps caused by copayments and deductibles that are not covered by most major medical plans.
Life Insurance: Enables you to tailor coverage for your individual needs and helps provide financial security for your family members. Term and Whole Life coverage are available.
Please contact the City’s Colonial representative Garth Brown to enroll in the program. Phone: 617-293-7108, Email: garth.brown@coloniallife.com.
The City offers a long term disability policy through Sun Life, administered by Mosse & Mosse. This policy will allow employees to purchase voluntary coverage.
Please read carefully the following description of your Sun Life Income Protection Plan insurance.
Please refer to the full document for additional information on the LTD Plan.
Your Plan Eligibility
You are eligible for disability coverage if you are an active employee in the United States working a minimum of 20 hours per week. The date you are eligible for coverage is the later of: the plan effective date; or the day after you complete the waiting period.
Current Employees: Current employees may enroll at any time and will be required to complete an enrollment form and an evidence of insurability form. Your coverage will be medically underwritten, and will not begin until Unum determines that you qualify based on information you provide regarding your health history.
New Hires: You may apply for coverage without answering any medical questions or providing evidence of insurability if you apply for coverage within 31 days after your eligibility date. You can apply any time during the year, however, if you apply more than 31 days after your eligibility date, your coverage will be medically underwritten, and your coverage will not begin until Unum determines that you qualify based on information you provide regarding your health history.
Benefit Amount
You may purchase a monthly benefit of either 40% or 60% of your monthly earnings, but not to exceed a monthly maximum benefit of $10,000. The definition of earnings is your current salary.
The total benefit payable to you on a monthly basis (including all benefits provided under this plan) will not exceed 100% of your monthly earnings unless the excess amount is payable as a Cost of Living Adjustment. However, if you are participating in Sun Life's Rehabilitation and Return to Work Assistance program, the total benefit payable to you on a monthly basis (including all benefits provided under this plan) will not exceed 110% of your monthly earnings (unless the excess amount is payable as a Cost of Living Adjustment).
Elimination Period
The Elimination Period is the length of time of continuous disability, due tosickness or injury, which must be satisfied before you are eligible to receive benefits. Your Elimination Period is 90 days.
Deferred Compensation is offered through Empower, Equitable and Nationwide. If you're interested in enrolling, you will need to contact the applicable vendor directly.
Enrollment in a 457B is a two-part process. You will need to go to our third party administrator’s website and submit a salary reduction agreement using the following link
https://www.tsacg.com/individual/plan-sponsor/massachusetts/city-of-somerville-457(b)/
Employees should contact TSA at (850-362-6840) with any questions.
Once you have completed that process, contact the vendor you have selected using the contact information below to make your investment elections.
457(b) Deferred Compensation Plan Providers |
|
255 Bear Hill Road Phone: 800-701-8255 Contact: Alex Mendoza |
|
40 William Street , Suite 200 Contact: Timothy Weaton Contact: Brandon Eigenberg |
|
Nationwide Retirement Solutions Contact: Eli Gonzalez, CRES, Senior Retirement Specialist |
Information
If you are happy with your insurance coverage, you do not need to do anything during this Open Enrollment.
If you wish to enroll or make changes to your benefits, please complete the appropriate form(s) or process found below by May 1st. Any changes received after May 1st will not be processed.
- Health Insurance changes must be submitted via the myGIC Link online portal. You may also contact the benefits team for a link to the form if you have any issues accessing the system.
- Dental, Vision, Group Life and Long Term Disability forms are online as fillable forms. Submit forms ONLY to benefits@somervillema.gov email for processing. Please do not send your enrollment/change forms to any individual member of the Benefits Team.
Submit forms ONLY to benefits@somervillema.gov email for processing. Please do not send your enrollment/change forms to any individual member of the Benefits Team.
- Flexible Spending - Open Enrollment for Flexible Spending will occur in November 2024, for coverage effective date of January 1, 2025. Those currently enrolled will need to re-enroll for coverage in the 2024 calendar year.
If you have any challenges, please call the benefits line at ext 3324 or send an email to benefits@somervillema.gov and a member of the benefits team will assist you through the process.
Reminder: If you are currently not enrolled in the City’ s Health Insurance and eligible, you are required to submit a HIRD form to Personnel by Wednesday, May 1st. This is an annual requirement.
Payroll Deductions for Health, Dental, Vision and Group/Voluntary Premiums
New deductions for health, dental, vision and life insurance will go into effect as of the first pay in June as deductions are taken the month prior to the coverage effective date of July 1st. Please see below the breakdown of when the new rates will be reflected in you pay:
Paycheck dated June 7, 2024, for City Weekly – 52
Paycheck dated June 28, 2024, for City Monthly – 12
Paycheck dated June 5, 2024, for School Weekly – 52
Paycheck dated June 4, 2024, for School Biweekly – 26
For those employees that are not paid during the summer months (School Weekly – 42, School Biweekly –21 and School Biweekly – 26 (SAA &209) paying benefits on a 21 schedule, your scheduled health, dental and basic life deductions will be updated on the first payroll in September 2024. A follow up communication will be sent on how deductions will be processed in May/June 2024 to capture the new rate differentials for the prepaid summer months.
Health
- GIC Benefit Decision Guide
- Health Insurance Responsibility Disclosure (HIRD) form
- Enroll in a GIC Plan (New Members Only)
- Change or Cancel Your GIC Plan (Current Members Only)
- Health Plan Rates for All Members
- Premium Assistance Under Medicaid and the Children's Program (CHIP) Notice
Opt Out
- Health Insurance Opt-Out Program Policy for Active Employees
- Health Insurance Opt-Out Program Voluntary Waiver of Insurance for Active Employees
- Health Insurance Opt-Out Program Policy for Retirees
- Health Insurance Opt-Out Policy Waiver for Retirees
- Health Insurance Responsibility Disclosure (HIRD) form
Dental
- Cigna Low Plan Summary of Benefits
- Cigna High Plan Summary of Benefits
- FY2025 Dental-Vision-Life Insurance Retiree Rates
Vision
- VSP Summary of Benefits
- VSP Member Enrollment Form
- FY2025 Dental-Vision-Life Insurance Retiree Rates
Group Life
- Boston Mutual Enrollment/Refusal Form
- Boston Mutual Evidence of Insurability Form
- Boston Mutual HIPAA Form
Long Term Disability
Welcome to the City of Somerville FY2025 Open Enrollment! Open Enrollment begins on April 3rd and ends on May 1st with benefit changes being effective as of July 1, 2024. The benefits described here are some of the benefits offered by the City of Somerville to benefits eligible retirees and surviving spouses.
What’s New?
Health
- As of July 1, 2024 all Unicare plans will change names to Wellpoint. There are no substantive health insurance plan changes this year. Please be sure to visit the Group Insurance Commission’s (GIC) web page at mass.gov/gic for information.
- Members may review their options and make elections by May 1st or will automatically remain on their current plan.
- Please be sure to review the a FY2025 GIC Benefit Decision Guide.
- GIC Rates have been updated.
Health Insurance Opt Out
- No changes.
Dental
- No plan design changes; however rates have increased by 4%.
- Cigna now only offers digital cards. New cards will not be sent with new enrollments, however if you have your old card it will remain active.
Vision
- No plan design or rate changes.
Group Life
- No plan design or rate changes.
Health
The Group Insurance Commission (GIC) has new premium rates for FY2025. The retiree/surviving spouse contribution rates will remain at 20% for the HMO, PPO & POS plans. Indemnity plans will also hold the current contribution rate of 25%.
The GIC’s main changes for FY2025 are in the rate increases ranging from 5-11% on active plans and 1.9-7% on Medicare supplemental plans depending on the plan. In addition Unicare has a name change to Wellpoint as of July 1, 2025.
Please be sure to visit the Group Insurance Commission’s (GIC) web page at mass.gov/gic for complete information regarding plan changes.
Also, take this opportunity annually to review the GIC Benefit Decision Guide for further understanding of the details of your health plan. Reference the Summary of Benefits for a comparison of all health plans offered.
GIC Electronic Enrollment/Change Process Through myGIC Link Portal
Information
Health Insurance Opt-Out
For those retirees who are eligible for and choose to enroll in the Health Insurance Opt-Out Program, please ensure you complete all the appropriate forms and documentation by May 1st to enroll in the program as of July 1, 2024. Please find the opt-out details in the attached revised policy below.
Forms and Information
- Health Insurance Opt-Out Program Policy for Retirees
- Health Insurance Opt-Out Policy Waiver for Retirees
Vision
Your vision insurance benefits will continue to be provided by Vision Service Plan. The vision benefit allows you to purchase voluntary vision coverage at a relatively low cost and is 100% retiree contributory. The plan design and rates remain fixed for FY2025.
Forms and Information
- VSP Summary of Benefits
- VSP Member Enrollment Form
- FY2025 Dental-Vision-Life Insurance Retiree Rates
Dental
The dental rates for FY2025 have increased by 4%. Benefit allowances will remain the same.
Your dental insurance benefits are provided by Cigna with the Low and High Plan options. The dual plan design allows for more affordable coverage. Please find additional detail on both the high and low plans below as well as responses to frequently asked questions.
Forms and Information
- Cigna Low Plan Summary of Benefits
- Cigna High Plan Summary of Benefits
- FY2025 Dental-Vision-Life Insurance Retiree Rates
- Requesting Cigna Digital Card
Life
Your Group Life plan design remains the same for FY2025. The basic group life employee contribution remains fixed at $5.53 a month. Your Group Life coverage is 50% employee contributory. Your life insurance benefits will continue with our current provider, Boston Mutual.
Open Enrollment Process and Instructions
If you wish to make a change to any of your plans, you will need to complete the applicable forms or process on the City's Open Enrollment website at http://www.somervillema.gov/openenrollment
Do I need to do anything this year?
If you are happy with your plans, no action is required.
If you wish to make a change to any of your plans, you will need to complete the applicable forms or process available on the City's Open Enrollment website at http://www.somervillema.gov/openenrollment
CHANGES SHOULD BE SUBMITTED ELECTRONICALLY
Health Insurance changes must be submitted via the NEW myGIC Link online portal. You may also contact the GIC at (617)727-2310 and speak with a Retirement Unit representative for assistance.
Dental, Vision, Group Life and Long Term Disability forms are online as fillable forms.
Submit forms ONLY to benefits@somervillema.gov email for processing. Please do not send your enrollment/change forms to any individual member of the Benefits Team.
If you have any challenges, please call the benefits line at ext 3324 or send an email to benefits@somervillema.gov and a member of the benefits team will assist you through the process.
Payroll Deduction changes for Insurance Premiums
Coverage changes will go into effect on July 1, 2024. Deductions are prepaid hence your new rates will be reflected in the June 2024 pension.
QUESTIONS:
Please contact the benefits line at 617-625-6600 ext. 3324 or via email at benefits@somervillema.gov and a representative from the Benefits Team will assist you.
If you have any questions regarding your benefit information, please feel free to contact the Benefits Team on the Benefits line at 617-625-6600 x3324 or via email at benefits@somervillema.gov.
- Health - Group Insurance Commission (GIC) 617.727.2310 mass.gov/gic
- Harvard Pilgrim Health Care 1.866.874.0817 harvardpilgrim.org/gic
- Health New England 1.800.842.4464 hne.com/gic
- Mass General Brigham Health Plan 1.866.567.9175 massgeneralbrighamhealthplan.org/gic-members
- Wellpoint 1.800.442.9300 wellpointmass.com
- Pharmacy Benefits – CVS Caremark 877.876.7214 info.caremark.com/oe/gic
- Health Insurance Opt Out - Benefits Line ext. 3324
- Flexible Spending – VOYA 1-888-401-FLEX (3539) voya.com
- Dental - Cigna 1-800-Cigna24 Cigna.com
- Vision – Vision Service Plan 1-800-877-7195 VSP.com
- Life - Boston Mutual 1-800-669-2668 BostonMutual.com
- Short Term Disability - Colonial Life Garth Brown 617-293-7108 garthbrown@coloniallife.com
- Long Term Disability - Sun Life Financial Administered by Mosse & Mosse Brian Fitzgerald 781-224-1709 ext. 139 brf@mosseservices.com
- Deferred Compensation (3 vendors)
- Equitable Timothy Weaton 781-237-8232 timothy.weaton@equitable.com
- Empower Customer Service 800-672-7240 www.empower-retirement.com
- Nationwide Eli Gonzalez 508-250-9796 GonzE21@nationwide.com
For those employees who are not on the All City or All School email distribution lists, please email the Benefits Team at benefits@somervillema.gov with your email address and you will be manually added to the Benefits email distribution list. Thank you!
