An employee can change from family to individual coverage within 60 days of a qualifying status change event following the procedures below.

The employee must complete and sign the following:

For Health Insurance:

  • GIC Enrollment/Change Form (Form-1)

The employee must provide documentation of the qualifying status change event.  For example, in the case of death of spouse or dependent, a copy of the death certificate is required.

For Dental/Vision:

  • Dental/Vision Enrollment/Change Form (Form-1DV)

The employee must provide documentation of the qualifying status change event.  For example, in the case of death of spouse or dependent, a copy of the death certificate is required.

For All Changes:

  1. Verify that the forms above are completed accurately and completely.  Ensure that both you and the employee have signed and dated all forms.
  2. Enter the change in the GIC MAGIC system.
  3. Photocopy completed GIC form(s) and documentation of qualifying status change event  and file them in the employee’s personnel file.
  4. Send original signed forms to the GIC along with the documentation of the qualifying status change event.  Forms and documentation must be received at the GIC within 60 days of the event.  Forms and documentation received after 60 days are returned and the employee may re-apply during Annual Enrollment.

NOTE:  The GIC may not be able to remove a dependent if there is a court order on file at the GIC requiring the employee to cover the dependent. 

This information provided by the Group Insurance Commission .