Health Insurance Responsibility Disclosure (HIRD) form for HR/CMS Agencies and UMASS doc format of    HIRD_Form_HRCMS_UMass.doc  - for GIC-eligible employees who do not elect GIC coverage and for non-GIC eligible employees who do not elect to pay for health insurance through the Commonwealth-sponsored Section 125 Plan.

Health Insurance Responsibility Disclosure (HIRD) form for Offline Agencies and Municipalities - for GIC-eligible employees who do not elect GIC coverage and for non-GIC eligible employees who do not elect to pay for health insurance through your Section 125 Plan.


This information provided by the Group Insurance Commission.