HomeMy WebLinkAbout7/1/2024 - 6/30/2027 MEMORANDUM OF AGREEMENT
BETWEEN
THE TOWN OF NORTH ANDOVER
AND
THE NORTH ANDOVER PUBLIC EMPLOYEE COMMITTEE
July 1, 2024 to June 30, 2027
WHEREAS, the Town of North Andover provides health insurance benefits to its employees
pursuant to M.G.L. c32B; and
WHEREAS,the Town, by a vote of its Select Board on February 6, 2012, adopted the provisions
of M.G.L. c32B, §§21 through 23, as amended by Chapter 69 of the Acts of 2011, for the purpose
of implementing changes in health insurance benefits it provides to its employees; and
WHEREAS, the Town, through its Town Manager, and the Public Employee Committee (PEC)
entered into a Memorandum of Agreement to transfer the Town's employees to the Group
Insurance Commission (GIC)pursuant to M.G.L. c32B, §23 effective January 1, 2014 through at
a minimum, June 30, 2027; and
WHEREAS,the Town and the PEC entered into this agreement for the sole purpose of transferring
to the GIC and recognize that in the event that the Town and PEC withdraw from the GIC, health
insurance bargaining will return under the jurisdiction of M.G.L. c150E; and
WHEREAS, the PEC unanimously voted to extend the Memorandum of Agreement for an
additional three (3) year period from July 1, 2024 through June 30, 2027;
NOW THEREFORE,the Town and the PEC agree as follows:
1. The Town of North Andover and the North Andover Public Employee Committee agree to
provide health insurance coverage through the Group Insurance Commission.
2. For purposes of this agreement,the term"Subscribers"shall mean;all employees,retirees,
dependents or survivors, who pay the monthly insurance premium and are insured and
eligible under Chapters 32A and B, subject to the rules of the Group Insurance
Commission. The Town retains the right to adopt rules and regulations as provided for
under M.G.L. c32B, §14.
3. For purposes of this agreement, the term "Active" employee* shall mean an individual
employed by the Town of North Andover who is eligible and enrolled in the Town's health
insurance. Employee must regularly work a minimum of twenty (20) hours per week or
more and be enrolled in the Essex Regional Retirement System (ERRS) to be eligible for
the Town's health insurance. Employees who are enrolled in the Massachusetts Teacher's
Retirement System (MTRS) and work 18.75 hours per week or more are eligible to enroll
in the Town's health insurance.
*Employees in collective bargaining units should refer to the applicable bargaining
agreement for language regarding re-hires, layoff, etc. If an employee is rehired by the
Town within two (2) years of the date last employment, they would pay the contribution
rate previously paid.
4. For purposes of this agreement, the term "Retiree" shall mean an individual who was
employed by the Town, is eligible to receive a pension and is entitled to health insurance
benefits under Chapter 32B.
5. For purposes of this agreement, the term "Medicare eligible retiree" shall mean an
individual who was employed by the Town, is eligible to receive a pension and is entitled
to health insurance benefits under Chapter 32B who has reached the age of 65 and is
eligible to enroll in Medicare insurance through the federal government.
6. For purposes of this agreement, the term "Non-Medicare eligible retiree" shall mean an
individual who was employed by the Town, is eligible to receive a pension and is entitled
to health insurance benefits under Chapter 32B who has not reached the age of 65 or who
is not eligible for Medicare insurance through the federal government (i.e. does not have
sufficient quarters in Social Security or never paid the Medicare tax through a payroll
deduction).
7. For purposes of this agreement, the term "Retired Municipal Teachers (RMT)" shall
mean a retired North Andover School Department Teacher who was receiving Group
Insurance Commission health insurance coverage prior to the Town joining the GIC on
January 1, 2014.
8. For purposes of this agreement, the term "Survivor" shall mean the legal spouse of an
employee or retiree who meets the requirements for the surviving spouse to receive benefits
under GIC rules and regulations. To be eligible as a surviving spouse,the survivor must be
enrolled in the Town's health insurance at the date of the subscriber's death. A Survivor
in the Column A or Column B contribution rate who drops coverage and re-enrolls shall
be grandfathered in the Column A or Column B contribution rate they previously paid.
o GIC Survivors Information
https://www.mass.gov/service-details/gic-survivor-health-insurance
Remainder of page intentionally blank
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Premium Contribution Rate for Active and Non-Medicare Eligible
Retiree, Spouses and Survivor Subscribers
9. Premium contributions under the GIC for Active and Non-Medicare Eligible Retirees,
Spouses, and Survivor Subscribers shall be based on the chart below. * ** ***
COLUMN A COLUMN B
Percent Percent
Contribution of Contribution of COLUMN C
Active and Non- Percent Contribution of
Active and Non-Medicare Eligible Medicare Eligible Non-Medicare Retired
HEALTH PLAN PLAN Retirees,Spouses Retirees,Spouses Municipal Teachers
TYPE/CATEGORY and Survivors and Survivors (RMT)Subscribed and
Subscribed and Subscribed and Retired Prior to
Retired Prior to Retired as of December 31,2013
December 31,2012 January 1,2013 and
beyond
IND FAMILY IND FAMILY IND FAMILY
Harvard Pilgrim Access America PPO/National 50% 50% 50% 50% 25% 25%
Network
Wellpoint Total Choice Indemnity/Broad
50% 50% 50% 50% 25% 25%
(Formerly UniCare Total Choice) Network
Wellpoint Plus PPO-Type/Broad ° °
(Formerly UniCare Plus) Network 25/ 25/ 25/ 25/ 15/ 15/Harvard Pilgrim Explorer POS/Broad 25% 25% 35% 35/°° 15/° 15/0°
Network
Mass General Brigham Health Plan HMO/Broad ° ° °
Complete HMO Network 25/ 25/ 25/ 25/° 15/° 15/Health New England HMO/Regional 25% 25% °
Network 25/ 25/ 15/ 15/
Wellpoint Community Choice PPO
(Formerly UniCare Community Choice) Type/Limited 20% 20% 20% 20% 15% 15%
Network
Harvard Pilgrim Quality HMO/Limited 25% 25% ° 25% 15% °
Network 25/ 15/°
*Active employees enrolled in the Town's insurance prior to December 31, 2012 and enrolled at the
date of the MOA(February 14, 2019) are grandfathered at the Column A percentage contribution rate
in perpetuity.
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**An employee grandfathered in the Column A contribution rate who drops coverage and re-enrolls
shall pay the Column A contribution rate.
***The Wellpoint Total Choice Indemnity Plan and the Harvard Pilgrim Access America PPO/National
Network Plan are exempt from grandfathering (except for Retired Municipal Teachers (RMT)). The
rate of those plans is 50%150%regardless of date of enrollment.
Premium Contribution Rate for Medicare Eligible Retirees
10. Subscribers who are eligible or who become eligible for Medicare shall enroll in Medicare
coverage.
11. For the duration of this Agreement, premium contributions under the GIC for Medicare
enrolled Subscribers shall be based on the following chart:
Column B
Retired Municipal
Column A Teachers(RMT)
Medicare Retirees, Retirees,Spouses,
Health Plan Plan Type/Category Spouses,and and Survivors
Survivors Per Subscribed and
Person Coverage* Retired
Before January 1,
2014 Per Person
Coverage"
Tufts Medicare Preferred Medicare Advantage/HMO 30% 15%
Limited Network
Wellpoint Medicare
Extension Medicare Supplement/Indemnity 0
(Formerly UniCare National Network 30% 25/0 Medicare Extension)
Harvard Pilgrim Medicare Medicare Supplement/Indemnity 30% 25%
Enhance National Network
Health New England
Medicare Supplement Medicare Supplement/Indemnity 30% 25%
Plus National Network
*North Andover School Department teachers who retired or have enrolled on or after January 1,2014,
the"Medicare Retirees,Spouses,and Survivors"rates in Column A apply.
**The term "Retired Municipal Teachers" (Column B) shall mean a retired North Andover School
Department Teacher who was receiving Group Insurance Commission health insurance coverage prior
to the Town joining the GIC on January 1, 2014.
Premium Contribution Rate for NON-Medicare Eligible Retirees
12. Premium contributions for Non-Medicare eligible Retirees is dependent upon the
individual's retirement date, date subscribed to health insurance, and Union or Non-Union
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status at time of retirement.
A. The following chart contains the premium contribution rates for HMO and HMO-Type
plans available to Non-Medicare eligible Retirees
For the following Plans:
• Mass General Brigham Health Plan
• Health New England
• Harvard Pilgrim Quality
Union/Non-Union Family Plan Individual Plan
Non-Union Personnel
Prior to September 1,2006 15.0% 14.0%
On or after September 1,2006 25.0% 25.0%
All Municipal Unions
Prior to July 1,2010 15.0% 14.0%
July 1,2010—June 30,2011 18.3% 17.6%
July 1,2011 —June 30, 2012 21.6% 21.3%
On or after July 1, 2012 25.0% 25.0%
School Nurses
Prior to December 31,2013 15.0% 15.0%
On or after January 1, 2014 25.0% 25.0%
School Cafeteria Staff
Prior to July 1, 2009 15.0% 14.0%
July 1,2009—June 30,2010 18.3% 17.6%
July 1, 2010—June 30,2011 21.6% 21.3%
On or after July 1,2011 25.0% 25.0%
Teachers
Prior to December 31,2013 15.0% 15.0%
On or after January 1,2014 25.0% 25.0%
School Administrative Assistants
Prior to July 1, 2011 15.0% 14.0%
July 1,2011 —June 3 0, 2012 18.3% 18.3%
July 1,2012—December 31,2012 21.6% 21.6%
On or after January 1,2013 25.0% 25.0%
School Professional Support
Prior to September 1,2012 15.0% 14.0%
Sept 1,2012—December 31,2012 20.0% 20.0%
On or after January 1, 2013 25.0% 25.0%
School Custodians
Prior to December 1,2012 15.0% 14.0%
Dec 1, 2012—Dec 31,2012 20.0% 20.0%
On or after January 1,2013 25.0% 25.0%
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HMO Plans Family Plan Individual Plan
Retired Municipal Teachers 15.0% 15.0%
(RMT)Retired and Subscribed as
of December 31, 2013
Retired and subscribed on or after 25.0% 25.0%
January 1,2013
B. The chart below contains the premium contribution rates for PPO, PPO-Type, and POS
plans available to Non-Medicare eligible Retirees.
For the Following Plans:
• Wellpoint Plus -PPO
• Harvard Pilgrim Explorer-POS
• Wellpoint Community Choice -PPO
PPO,PPO-Type Plans Family Plan Individual Plan
Retired Municipal Teachers 15.0% 15.0%
Retired and Subscribed as of
December 31,2013
Retired and Subscribed as of 25.0% 25.0%
December 31,2012 20.0%Wellpoint Community 20.0%Wellpoint
Choice Community Choice
Retired and Subscribed on or after 25.0% 25.0%
January 1,2013 20.0%Wellpoint Community 20.0%Wellpoint
Choice Communill Choice
POS Plans Family Plan Individual Plan
Retired Municipal Teachers 15.0% 15.0%
(RMT) Retired and Subscribed as
of December 31, 2013
Retired and Subscribed as of 25.0% 25.0%
December 31, 2012
New Subscribers Retired or 35.0% 35.0%
Subscribed on or after January 1,
2013
C. The chart below contains the premium contribution rates for the following plans available
to Non-Medicare eligible retirees:
• Harvard Pilgrim Access America(PPO/National Network)
• Wellpoint Total Choice (Indemnity/Broad Network)
Family'Plan Individual Plan
Retired Municipal Teachers(RMT) 25.0% 25.0%
Retired and Subscribed as of December 31,2013
Retired and Subscribed as of December 31,2012 50.0% 50.0%
New Subscribers Retired and Subscribed on or 50.0% 50.0%
Plan Changes on or after January 1, 2013
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New Plans Offered for the Duration of this Agreement
13. If the GIC offers any new or additional plans to Active or Retired Subscribers during the
life of this Agreement,the Town and the PEC will agree to reopen the contract for
Sections 9 and 11 only.
Waiting/Hiatus Period
14.New employees of the Town are eligible to enroll in health insurance offered by the GIC
in accordance 805 CMR 9.01. Therefore, in accordance with 805 CMR 9.01(3), new
employees of the Town are eligible to enroll in health insurance offered through the GIC
within ten(10) calendar days of the first date of employment with the Town. Eligibility for
insurance coverage will be determined in accordance with Massachusetts General Laws
and applicable regulations,including but not limited to, 805 CMR 9.01.The period between
the date of employment and the effective date of coverage pursuant to 805 CMR 9.01(3) is
hereinafter referred to as the "Waiting/Hiatus Period." GIC health insurance benefits begin
on the first day of the month following the GIC's waiting/hiatus period.
15. During the "Waiting/Hiatus Period,"the Town shall pay a"Waiting/Hiatus Period Stipend"
(Stipend) to those newly hired employees who have notified the Town within ten (10)
calendar days of employment that they have chosen to enroll in one of the health insurance
plans through the GIC. The amount of the Stipend will be equal to the employee's portion
of the premium or cost for whichever plan the employee has chosen to enroll in up to a
maximum of 80%. To receive the Stipend, the employee must show proof of other health
insurance coverage during the "Waiting/Hiatus Period," (e.g., COBRA or other alternative
health insurance plan).
16.Newly enrolled employees/Subscribers who cancel their GIC coverage within thirty (30)
days of the effective date of the GIC coverage shall return the Stipend in its entirety to the
Town.
17. GIC Retroactive Effective Date of Coverage: Subscribers may request retroactive
coverage from the GIC in accordance with 805 CMR 9.01(4). Therefore, if a subscriber
incurs an unplanned or urgent medical expense(s) during the "Waiting/Hiatus Period" that
in sum exceeds the full-cost health insurance premium of the GIC's elected plan for the
"Waiting/Hiatus Period", the subscriber may file a written request to the GIC for approval
of health coverage to become effective on the first day of employment. Upon approval by
the GIC, coverage shall take effect as of the first day of employment. In this event, the
Town shall submit the full-cost health insurance premium for the "Waiting/Hiatus Period"
to the GIC in a timely manner. The employee shall reimburse the Town for the premium
and any Stipend amount already received through normal payroll deductions.
18. The provisions of subparagraphs 16, 17, 18 and 19 shall expire if and when the GIC
eliminates the "Waiting/Hiatus Period" as set forth in 805 CMR 9.01.
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Opt-Out Program
19. For subscribers currently on the Town Health insurance and for current Opt-Out program
participants who remain unenrolled in Town health insurance in the subsequent fiscal
year(s) a per-payroll payment will be made to equal on an annual basis:
• $3,000 for individual plans; and
• $6,000 for family plans.
See Appendix A for Opt-Out Program language
Health Coverage after June 30, 2027
20. The enrollment of Subscribers to the GIC shall remain in effect after June 30,2027,unless,
pursuant to a successor Agreement executed by the parties, notice is provided to the GIC
no later than December 1, 2026, that the Town will terminate its coverage with
the GIC.
21. The Town Manager, or his designee, and the PEC shall commence negotiations for a
successor agreement no later than July 1, 2026. The PEC will evaluate any and all factors,
including average annual rate increases, to extending the coverage for an additional three
(3) year period from July 1, 2027 through June 30, 2030. To facilitate negotiations, by
December 31, 2026, the Town shall request specific utilization and claims data from the
GIC pursuant to GIC CMR 8.05,Paragraph(29), §§a-b which shall be made available for
examination by the PEC.
Public Employee Committee (PEC) Meetings
22. The Public Employee Committee shall be composed of one (1) union officer from each
collective bargaining unit which negotiates with the Town and a retiree representative
designated by the Retired State, County and Municipal Employees Association. Each
union officer and the retiree representative shall have the option of allowing one
additional representative to attend meetings of the Public Employee Committee with the
Town.
23. The parties may establish a regular schedule of meetings to discuss the implementation of
this agreement and any issues relating to the effectiveness and efficiency of health
coverage for Subscribers. Such meetings may take place no less than quarterly, unless
agreed otherwise. Meetings will be held at times and places which are mutually agreed
upon by the Town and the Committee. In addition, either party may convene a meeting
upon seven (7) calendar days' notice to the other party, unless there is an emergency that
requires shorter notice. Meeting notices will be provided to the Town and to the Public
Employee Committee to the person and in the manner designated in writing by the Town
and the Committee.
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24. Any employee who is a representative on the Public Employee Committee shall receive
time off to attend meetings of the Committee with the Town with full pay, if meetings are
during the employee's normally scheduled work hours.
Correspondence
25. The Town, through the Town Manager's Office or his/her designee, shall copy the
members of the Public Employee Committee on correspondence related to the Agreement
between the Town of North Andover and the Group Insurance Commission. Electronic
copies may be substituted when available in that medium.
Agreement Interpretation
26. Employees who have questions regarding the content of this agreement or need assistance
with interpretation of the language are encouraged to contact (through their respective
Union representative) the Town or School's Human Resources Department, whichever is
applicable. Retirees who have questions regarding the content of this agreement or need
assistance with interpretation of the language are encouraged to contact (through their
respective Union representative)the Town's Human Resources Department.
The appropriate Human Resources Department will address the issue and respond in
writing to the party in a reasonable period of time. If the individual is not satisfied with
the response from the Human Resources Department, they may contact the Deputy Town
Manager for a meeting. If the individual is not satisfied with the written response from the
Deputy Town Manager, they may contact the Town Manager for a meeting. The Town
Manager will issue a written response to the individual's issues in a timely manner.
Severability Clause
27. If any provision or portion of this Agreement is found to be unenforceable or unlawful,the
remaining provisions or portions shall remain binding.
Scope and Modification
28. This "Memorandum of Agreement" shall constitute the whole of the Agreement between
the Town and the PEC. The Agreement may be modified only by a written agreement
approved in the same manner as the original Agreement.
Authorization to Sign Agreement
29. Each signatory to this Agreement is authorized to bind the entity he/she represents. The
PEC represents that it has the authorization and approval of a majority of the weighted
votes of the PEC and that this Agreement is binding on all Subscribers and their
representatives.
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Signatures:
E uted on behalf of the Town of North Andover:
Date:
elissa Murphy-Rodrigues, Esq. Town Manager
Exec �bef the Public Employee Committee: Date:
AT S E—Clerical
AFSC I Professional Librarians
AFSCME—Public Works
IAFF, Local 2035 —Firefighters
NEPBA, Local 102—Communications Officers
114--
NOBA, Local 2A—Police Officers
NE BA, Local 2B—Police Sergeants
North,Andov Cap ria Staff Association
North Andover Custodial Association
North Andover al Administrative Assistants Association
North Ando r Po ice Lieutenants
Z_JjLj I
"Koh Andover Teachers Association
Retiree eprese tiver
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APPENDIX A
Opt-Out Program
July 1, 2024 through June 30, 2027
For purposes of the Opt-Out Program, an Active employee is defined as an employee who
remains eligible for the employer's contribution rate (excludes unpaid leaves of absences) for
health insurance.
The Town shall establish an Opt-Out Program for Active employees who are enrolled on
the Town's health insurance plan and opt-out of the health insurance program under the
following terms and conditions:
a. The Opt-Out program is available to Active employees only;
b. The annual Opt-Out incentive shall be:
• Family coverage - $6,000
• Individual coverage - $3,000
• Change from family coverage to individual coverage - $3,000
C. All payments will be pro-rated based on the number of months in the fiscal year
the employee is not enrolled in the Town's health insurance and participating in
the Opt-Out program. Employees who voluntarily terminate insurance coverage
during the plan year will receive a pro-rated Opt-Out incentive using the
following formula:
Bi-Weekly Opt-Out= (Opt-Out Payment X (#of months w/o coverage ))/# of payrolls
remaining in fiscal year. 12
d. Opt-Out payments shall be made bi-weekly, according to the Town's regular
payroll practices.
e. To be eligible, active employees must meet one of the following criteria:
i. The employee has been continuously enrolled in the Town's health
insurance for a minimum of twenty-four (24) consecutive months;
ii. The employee is already participating in the Opt-Out Program and remains
unenrolled in Town insurance in the subsequent fiscal year(s);
iii. Employee with Change in Insurance Coverage During Plan Year:
(a) Employees who change insurance coverage from individual to family
coverage during the plan year and then later decide to Opt-Out of the
Town's health insurance will be eligible for the Opt-Out incentive in
the amount of$3,000.
(b) Employees who change insurance coverage from individual to family
coverage during the plan year and maintain family coverage for two
(2) years and then decide to exercise the Opt-Out will be eligible for
the $6,000.
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f. Employees who are enrolled in an individual plan, increase coverage to a family
plan and then decrease coverage to an individual plan are not eligible for the Opt-
Out Incentive;
g. Employees enrolled in an individual or family plan must show evidence of
alternative insurance coverage before they are allowed to Opt-Out of the Town's
health insurance;
h. The Town will pay the Opt-Out incentive via payroll on a bi-weekly basis, less
applicable payroll taxes. Payments are not pensionable. For school department
employees,payments will be made on the school payroll schedule. If an
employee needs to re-enroll on the Town's insurance, the Opt-Out incentive
payments will end on the first payroll that health insurance premiums are
deducted;
i. If there is a qualifying event in which an employee who has opted-out needs to
opt-back onto the Town's insurance,the employee will be eligible to do so as
long as enrollment is done within the sixty(60) days of the qualifying event.
Employees returning to the Town's insurance are grandfathered at the Column A
or Column B contribution rate they were paying;
j. Apart from a qualifying event, any employee who has opted-out can re-enroll in
the Town's health insurance during any open enrollment period;
k. Married Town employees (i.e. both working for the Town of North Andover) who
are currently enrolled in separate individuals plans may not enroll in a family plan
for purposes of receiving the Opt-Out incentive;
1. School department employees who participate in the Opt-Out incentive effective
on July 1 of the fiscal year will receive the Opt-Out incentive payment beginning
the second pay period in August(the first pay period of the school year).
M. The Opt-Out program will have a sunset provision of June 30, 2027;
n. Any issues or disputes that arise regarding enrollment periods or rules and
regulations relating to the implementation of this program shall be reviewed by
the Town's Human Resources Director. The Human Resources Director will
convene a committee comprised of two (2) representatives appointed by the Town
Manager and two (2)representatives appointed by the PEC. The committee shall
make a recommendation to the Town Manager. The Town Manager's decision
shall be final and binding; and
o. Employees who are no longer eligible for the health insurance benefit or terminate
employment are not eligible to participate or continue to receive the Opt-Out
incentive payment. If an employee is receiving the Opt-Out payment and passes
away,the Opt-Out payment will be terminated.
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APPENDIX B
FREQUENTLY ASKED QUESTIONS
Q: Can I enroll in health insurance when I retire even if I was never enrolled while I was
actively working?
A: Yes, as long as you are eligible to receive a pension when you retire,you are eligible to
enroll in health insurance at retirement.
Scenario 41- John is an active employee who was not subscribed to GIC health insurance at the
time of his retirement. Rather, he was a dependent on his spouse's health insurance plan. John is
eligible to subscribe to GIC insurance at the time of his retirement. If John decides not to enroll
in GIC insurance at the time of his retirement, he may enroll within sixty (60) days of any
qualifying event(e.g. involuntary loss of coverage elsewhere, marriage, or spouse's open
enrollment). John may also enroll in GIC insurance during the annual enrollment period which
typically runs from early April to early May.
Q:Is my spouse eligible for GIC survivor benefits if I die?
A: Yes, as long as the employee (or retiree) and their surviving spouse are receiving GIC
health benefits at the time the employee (or retiree) dies.An exception applies to spouses who
are enrolled in health insurance through the Commonwealth or a different Municipal
Employer.
Scenario 41- John, who is retired, enrolls in GIC insurance during annual enrollment. He also
enrolls his spouse, Barbara, during annual enrollment. John later passes away. Barbara is eligible
for survivor benefits because John and Barbara were enrolled at the time of John's death. See
PEC Agreement, Section 8, "To be eligible as a surviving spouse, the survivor must be enrolled
in the Town's health insurance at the date of the subscriber's death."
Scenario 42-After retirement, John cancels his own GIC health insurance plan and sadly passes
away. In this case, Barbara is not eligible for surviving spouse benefits because John was not a
subscriber when he died. See PEC Agreement, Section 8.
Scenario 43-John, an active employee who is not subscribed to GIC health insurance, passes
away. His wife Barbara is not eligible for surviving spouse benefits because John was not a
subscriber when he died. See PEC Agreement Section 8.
Scenario 44- John is an active employee who retires at the age of 62. At the time of his
retirement, John was enrolled in an individual health plan. His wife, Barbara, was enrolled in
health insurance through her private sector employer. Barbara was never covered under John's
insurance plan. After his retirement, John unfortunately passes away. Barbara is not eligible for
survivor benefits per the PEC Agreement Section 8.
Scenario #S-John is an active employee who retires at the age of 62. He was enrolled in an
individual health plan at retirement, while his wife had health insurance from her
State/Municipal employer. Barbara was never covered under John's insurance plan. After his
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retirement, John unfortunately passes away. Barbara must elect coverage through her
State/Municipal employer and is not eligible for survivor health coverage through the Town of
North Andover. See PEC Agreement, Section 8.
Q: Can I enroll in health insurance at retirement even if I participated in the Town's Opt-Out
program while I was actively working?
A: Yes, as long as the retiree is eligible to receive pension benefits at the time of retirement, the
retiree is eligible to enroll in health insurance regardless of whether they participated in the
Opt-Out program during their active employment.
Scenario 41-John is an active employee enrolled in HP Explorer through the GIC. His
contribution rate is 25% (Column A of the PEC Agreement). John later participates in the
Town's opt-out incentive program. John retires at age 62. At the time of his retirement, John was
not subscribed to health insurance, but he decides to subscribe to HP Explorer at retirement. John
will be the same contribution rate as he did when he was enrolled in HP Explorer prior to
participating in the opt-out program (25%).
Scenario 42-John is an active employee who never subscribed to GIC insurance during his
employment and never participated in the Town's Opt-Out program. John retires at age 62 and
subscribes for the first time to a GIC plan. John chooses HP Explorer. John will pay the
contribution rate in Column B of the PEC Agreement(35%).
Q: If I continue working after I turn age 65, does my GIC health insurance change?
A: No.Active employees remain in their active/non-Medicare employee health plan as long as
they are actively working.
Scenario 41-John is an active employee who turns age 65 and continues to work. John will
continue to be enrolled in his active/non-Medicare plan while he is actively working. If John is
enrolled in family plan, John's dependent spouse will continue to be covered as a dependent on
John's family plan regardless of her age.
Q:If I retire and I am over age 65, does my health insurance change?
A: Yes. Retirees who are age 65 or older will no longer be eligible for active/non-Medicare
plans. Instead, they will choose a Medicare Supplement Plan to enroll in.
Scenario 41-John retires at age 67. His spouse, Barbara, is age 62. John will enroll in a
Medicare Supplement plan for himself. Barbara will enroll in an active/non-Medicare individual
plan.
Scenario 42-John retires at age 67. His spouse, Barbara, is age 62. John and Barbara have a
dependent child under age 26. John will enroll in a Medicare Supplement plan. Barbara will
enroll in an active non-Medicare individual plan. Their dependent child will be enrolled in
another active/non-Medicare individual plan.*
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*UniCare (WellPoint) Exception: John is a retiree over age 65 who enrolls in UniCare
(WellPoint)Medicare Extension. If John's dependent spouse and dependent child are both under
age 65,they may enroll in one UniCare family plan at same contribution rate that John was
paying for his active UniCare family plan. John will only be required to pay a premium
contribution for the active/non-Medicare family plan. The Medicare premium for John's
Medicare Supplement plan in this instance would be waived. Only UniCare offers this.
Q:If I retire and I am under age 65, but my spouse is over age 65, does my health insurance
change?
A: Yes. Retirees who are under age 65 will enroll in an active/non-Medicare individual plan.
Their spouse over age 65 will enroll in a Medicare Supplement Plan.
Scenario #1-John retires at age 62. His spouse, Barbara is age 67. John will enroll in an
active/non-Medicare individual plan. Barbara will enroll in a Medicare Supplement plan.
Q:If my spouse and I are both under age 65 when I retire, does my health insurance change?
A: As long as the retiree and spouse are both under age 65, they may remain enrolled in an
active/non Medicare family plan. When one of them turns age 65, they will need to enroll in a
Medicare Supplement Plan and the other will enroll in an active/non-Medicare individual
plan.
Scenario #1- John retires at age 62. His spouse, Barbara, is age 60. John and Barbara may remain
enrolled in an active/Non-Medicare family plan. In 3 years, when John turns age 65, John will
enroll in a Medicare Supplement Plan and Barbara will enroll in an active/non-Medicare
individual plan. When Barbara turns 65, she will enroll in a Medicare Supplement Plan.
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Revision History:
Approved: December 18, 2012
Amended: October 16, 2014
Amended: March 17, 2015
Amended: November 30, 2015
Amended: November 1, 2016
Amended: November 14, 2017
Amended: February 14, 2019
Amended: December 1, 2022
Amended: May 15, 2023
Amended: January 9, 2023
Amended: September 27, 2023
Amended: March 28, 2024
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