If the employee is changing from individual to family coverage, follow the below procedures:
The employee must complete and sign the following:
For Health Insurance:
- GIC Insurance Enrollment and Change Form (Form-1).
- Insurance Data Form (IDF)
- 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 to 26 – Dependent Age 19 to 26 Enrollment and Change Form and a copy of birth certificate.
- Beneficiary Designation Form (Form 319) (one to three beneficiaries) or Nomination of Beneficiary Form G-500 (four or more beneficiaries or special designations such as estate and trusts)
Dental and Vision Enrollment and Change (Form-1) - See Dental/Vision Eligibility section for eligibility details. If family coverage is not elected for health insurance, but the employee wishes to have family dental/vision coverage, he/she must also submit a copy of a marriage certificate to cover a spouse and birth certificates to cover dependent children and a student verification form to cover a student dependent.
For All Changes:
- Verify that the forms above are completed accurately and completely. Ensure that both you and the employee have signed and dated all forms.
- Enter the change in the GIC MAGIC System.
- Photocopy completed GIC forms and file them in the employee’s personnel file.
- Send original signed forms to the GIC.
This information provided by the Group Insurance Commission.