Healthcare Mitigation FY23
The Healthcare Mitigation program was created using funds from the Massachusetts/MOSES Health & Welfare Trust Fund set aside for exclusive use in providing enhanced healthcare benefits to Unit 9 employees covered by the Commonwealth, MassDOT, and MWRA Collective Bargaining Agreements.
Qualifying expenses eligible for reimbursement through this program are those incurred through participation in a Healthcare Insurance Plan and that have been paid, excluding premiums. These qualifying expenses include Healthcare Plan co-payments and payments towards plan deductibles. Members receiving Healthcare through the Group Insurance Commission (GIC) can find a list of these qualifying expenses in the Fiscal Year 2023 GIC Benefit Decision Guide for Commonwealth of Massachusetts Employees. This document is available at https://www.mass.gov/lists/gic-benefit-decision-guides
The documentation required to receive this reimbursement must be a summary sheet of deductible and out-of-pocket expenses paid. If the backup documentation provides un-redacted sensitive medical information (i.e. diagnoses or treatment plans) the claim may be rejected. These summary documents are available through your Healthcare Insurer or their contractor (e.g. Express Scripts); and are available through their websites by logging into your account. The easiest and most comprehensive source of a summary document can be obtained through the Express Scripts, the Pharmacy Benefits Manager for GIC, login page at https://www.express-scripts.com/login. This site contains information about both prescription out-of-pocket expenses and other medical related out-of-pocket expenses. Even if you have not had a prescription filled this fiscal year, all needed information will be available through Express Scripts portal. A tutorial for accessing the necessary information through Express Scripts is available here.
Members receiving Healthcare coverage from plans outside of the GIC are eligible for reimbursement of similar qualifying expenses, provided they have the necessary documentation. The necessary documentation would be a similar summary document that does not contain sensitive medical information (e.g. diagnosis or treatment plans).
Much of the documentation required for reimbursement may not be easily available after June 30, 2023, when the GIC plans reset for the next fiscal year. Additionally, beginning July 1, 2023, CVS Caremark will replace Express Scripts as the GIC’s Pharmacy Benefits Manager. We do not know if you will be able to access this information on the Express Scripts website beyond that date. Please keep copies of all submitted materials. Reimbursement requests for Fiscal Year 2023 must be postmarked no later than July 31, 2023. Please note that putting your envelope in a mailbox on July 31, 2023, DOES NOT guarantee that the Post Office will postmark your envelope on that date. Requests for additional forms or questions should be referred to the Administrator by mail at the address listed below or by email: HealthcareMitigation@moses-ma.org.
Please submit the reimbursement request form and all necessary attachments to:
ADMINISTRATOR of Healthcare Mitigation Plan
Massachusetts/MOSES Health & Welfare Trust
PO Box 8099
Boston, MA 02114