Updated July 10, 2013
If an employee is not currently enrolled in GIC life and health insurance coverage, complete the following to enroll during Annual Enrollment:
- To select their basic life and health benefits, employees must complete the following forms completely and legibly:
- Insurance Enrollment and Change Form (Form-1)
- Beneficiary Designation Form 319 (one to three beneficiaries) or Nomination of Beneficiary form G-500 (four or more beneficiaries or special designations e.g. estate and trust).
- Insurance Data Form (IDF) for family coverage. Must also provide:
- For spousal coverage – copy of marriage certificate.
- For former spouse – provide following sections of the legal separation or divorce decree: page with absolute date, health insurance language, signature pages, and former spouse’s address.
- For dependent coverage under age 19 – copy of birth certificate(s) – the birth certificate must show the parent-child relationship to the insured or his/her spouse.
- For dependent coverage age 19 or over – Dependent Age 19 to 26 Enrollment form and a copy of birth certificate. For a handicapped dependent, a Handicapped Dependent Application. The birth certificate must show the parent-child relationship to the insured or his/her spouse.
- On the Insurance Enrollment and Change Form (Form-1), indicate the employee’s annual salary and effective date. Be sure to indicate the date of hire and annual salary.
- Enter life and health insurance elections into the MAGIC system.
- Photocopy completed GIC forms and file them in the employee’s personnel file.
- Send all original signed forms to the GIC.
If electing optional life insurance, the GIC will notify the life insurance carrier, which will send the employee a Medical Evidence of Insurability Application to complete and return. If the employee does not return the Medical Evidence of Insurability, their file will be closed. If the medical application is approved, the GIC will advise you and the employee. The GIC will determine the effective date and will update the GIC’s MAGIC system for premium deductions.
The employee should be automatically enrolled in pre-tax basic life and health insurance deductions unless he/she opts out of participating. This is known as a Section 125 Plan. See your payroll help desk for more information.
This information provided by the Group Insurance Commission .