Human Resources & EO

Health Insurance for Non-Benefited Employees & Dependents

Alternative Health Insurance for MA Residents & Dependents

Non GIC-Eligible Commonwealth Employees:

The Health Care Reform law requires that all Massachusetts residents have health insurance coverage that meets coverage standards under the Health Care Reform law or you may be subject to Mass. state penalty as a non-insured resident.

The Commonwealth of Massachusetts has established a Section 125 ("cafeteria") plan for state employees who are not eligible to receive state-subsidized health insurance through the Group Insurance Commission to purchase health insurance on a pre-tax basis from the Commonwealth Choice Programs available through the Commonwealth's Health Connector Authority. This includes employees who work les than 20 hours in a 40 hour workweek or less than 18 ¾ hours in a 37.5 hour work week, contract employees and seasonal employees.

Commonwealth Choice offers a choice of several health carriers, grouped into three different benefit levels and plans carry a Seal of Approval from the state's Health Connector which ensures high quality and good value. After you have chosen a plan the Commonwealth will arrange for you to pay for this coverage by making pre-tax payroll deductions from your bi-weekly paycheck which means you will not have to pay state or federal income taxes of the cost of your health care premiums. Although the Commonwealth will not contribute to the cost of the plan you choose, purchasing plans on a pre-tax basis can make health coverage more affordable.  Employer ID# 149683

Coverage periods are based on Commonwealth Choice receiving a full month's premium prior to the coverage Effective Date.  Note: health coverage will generally not be effective until at least 45 days after enrollment due to billing cycle time and payroll deductions. Your coverage will begin on the first day of the calendar month following the date you apply for enrollment and pay the premium amount due. (For example, if you enroll in July 15 and pay the premium amount due, your effective date of coverage will be August 1.) Your renewal date will be 12 months from your effective date, and then every 12 months thereafter. Once you elect your coverage you cannot change to a different plan (except in a few very specific situations) until your yearly renewal date. At your renewal date you will have the opportunity to change Commonwealth Choice Plans.  In some instances eligible employees can make additional pre or post tax payments to receive coverage prior to their effective date of coverage.

Cancellation of Coverage:

You can cancel your coverage any time by notifying the Connector in advance. Your coverage will end the last day of the calendar month in which you notify the Connector. You cannot cancel your coverage retroactively. If you cancel your coverage you are responsible to pay the premium amount due up until the effective date of your cancellation. Your coverage will be terminated by the Connector for any of the following reasons: failure to pay the full premium amount due; you no longer meet the Connector's or Plan's eligibility requirements; you have committed fraud or misrepresented your eligibility for coverage or the eligibility of your enrolled dependents; failure to provide information to the Connector which is reasonably necessary for it to verify your eligibility and continuing eligibility; and other reasons that the Commonwealth Choice Health Plan may state in its Evidence of Coverage booklet (for example if you move out the Plan's service area). The Connector will provide you written notice of termination to your last known address on file.

New Hires:

Eligible new hires have 45 days to enroll in a Commonwealth Choice health plan. Employees who do not enroll within 45 days can purchase individual Commonwealth Choice coverage on a post-tax basis. There is also one Open Enrollment period each year in which employees who didn't join initially can join, or change health care plans within the Connector.  Employer ID# 149683.

Legislative Requirements (HIRD Form):

Legislation requires employers to collect Employee HIRD (Health Insurance Responsibility Disclosure) Forms from employees who decline employer-sponsored health insurance or the employer's Section 125 Plan.  If you are eligible for GIC benefits and decline because you have health insurance through your spouse you also must complete this HIRD form checking off that you have declined both the GIC insurance as well as the 125 Cafeteria Plan insurance and checking off that you have insurance elsewhere.

Non-IRS Dependents (alternative coverage):

Read section on Coverage for Dependents (Age 19 or Over).  If you have a dependent who is a non-IRS dependent and you want to avoid paying imputed income taxes to carry this dependent on your health insurance, an alternative solution is to have your non-IRS dependent contact the Health Care Connector to see if there is a coverage plan which might be less expensive.

Benefited Employees Leaving State Service:

Benefited employees who leave state service will receive notification of continued coverage through COBRA, however, Commonwealth Choice premiums could be lower than COBRA costs and provide an alternative solution.

Connector Contact Information:

Connector Authority at 1.877.623.6765 and go to the Connector Website. If you have questions as to how to have these pre-tax deductions taken from your paycheck please contact Mary Ann Gachignard, payroll supervisor at Salem State University, at 978.542.7026.