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Group Insurance Commission of MA (GIC) General Information- 1/1 Launch (CVS)

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Axel Mora
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ATTENTION - CVS Group Orgs must be looked up with the "CVS MEMBER LOOKUP" tool and not in the general "Eligible users” section on B2B - see FAQ section below for more details.

GIC provides and administers high-quality, affordable health insurance and other benefits to the Commonwealth's Employees and Retirees, and their dependents and survivors. GIC also provides coverage to participating municipalities, Housing, and Redevelopment Authorities' personnel as well as to retired municipal employees and teachers in certain governmental units.
 

Landing Page: https://www.vida.com/gic/

We have a new dedicated line for this client only  +1 (888) 688-7188

Announcement: Starting 7/1/26 GIC will not offer GLP1 coverage, they are working on the verbiage and will provide further information as soon as it is approved, for now this what they want us to say to the members:
 

  1. Your use of the Vida program remains covered as part of your benefits.  If prescriptions are appropriate as part of your engagement with Vida, Vida prescribes based on what is covered in the formulary at that time
  2. If you need more details about current prescription coverage please contact the number on the back of your CVS Caremark ID card. (1-877-876-7214)
  3. A reminder that the effective date of this change is not until 7/1/26
  4. If you are on a GLP-1 for weight loss and wish to remain on it until the effective date, you must enroll and engage with Vida
  5. GIC will communicate with members once more details about a transition plan are available

 

GIC labs mobile app screen has been offering lab corp as a provider but it is actually not an in network provider for GIC. We are launching communication to the members around the suggestion to use an in network provider. We are also working on the labs section so it does not point to lab corp as first option for GIC

Programs & Devices Offered

Tier 3 Medical Weight Loss (Use Case 3)- AOM transitions  will have a 90 day grace period to 3/31/26

GIC members do have a 90 day grace period and should not be receiving denials. If you need to raise these to CVS, please escalate to Tier 2 and Tier 2 please  send the member details to the AMs Collin Fahey and Kerryanne Shuler

Population Details

  • Employees: 137,600
    • Spouses & Dependents:  93,379
    • Approximately 21,000 members are currently utilizing obesity-focused GLP-1  medications 
  • Total: 231,000

located in MA

There are about 2500 GIC transition members currently on mounjaro for obesity.  Vida communications are indicating that all members on weight loss medications must enroll in and be managed by Vida - communications to not call out medication names.

  • Since mounjaro (tirzepitide) is a diabetes medication being used off-label for obesity due to the CVS formulary change to exclude Zepbound (which is the tirzepitide for obesity) - there are GIC members who are currently being prescribed mounjaro for obesity that Vida will be communicating out to in order to enroll in Vida.Reality is that mounjaro (as a diabetes medication) will NOT be limited for GIC members to Vida providers only since it is not indicated for obesity.  Members filling mounjaro for obesity will not see a denial at point of sale on 4/1 like those on obesity meds will see.  However, given that GIC is expecting Vida to manage their members on weight loss meds and we want to continue to drive these members to Vida, we will continue to do that.

Additional Info

  • What segment is this org in?
    • Employer
  • Are there any Fees at risk (FAR) org?
    • Yes (No support related PGs)
  • When did we launch with this org?
    • 1/1/2026
  • How is the service being paid for?
    • Vida is available at no cost to all employees and their dependents aged 18+ enrolled in a GIC of MA medical plan
  • How do members enroll?
    • Vida App, VSC outreach campaign
  • Where should non-eligible members be directed?
  • Who is eligible?   Members, spouses, and dependents 18+ that are apart of a GIC Medical (Mass General, Harvard Pilgrim, Health New England, and Wellpoint) plan, those on Cobra, and retirees not on Medicare are eligible for Vida. Retirees on Medicare are not eligible. 
  • Is the org on the eligibility file?
    • YES
      • IMPORTANT:Pay orgs under our CVS partnership - Lincoln Financial, Schnuck’s Markets, RYAM, Morton Salt, OnVida Health, Charter Communications, Ecolab, Mondelez, KeHE Distributors, Blue Compass RV, Henkel etc  - go through a specific eligibility check that verifies against an external file in real time during enrollment. Right now, the “Eligible users” for these orgs in our B2B system reflect only marketing details and cannot be assumed to be accurate for eligibility checks.
        In order to check members eligibility through these orgs,
        • click the “CVS MEMBER LOOKUP” icon on the top right corner of the B2B system.
        • Select the specific org from the drop-down and fill details (best case is to try their Caremark ID - most members should have their Caremark ID available). If using Caremark ID, no other details are needed. If using Name, make sure to include first and last name with proper spelling, birthday, and Zip Code.
  • How often will terminations take place?
    • Monthly 
  • Do we offer Phone and/or Email support?
    • Phone + email
  • Is VSC outreach involved?
    • Yes
  • CVS Benefit Change FAQ

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