For insureds who want to cancel their GIC life, long term disability, dental/vision and/or individual health insurance coverage:
- Employee completes and signs GIC Insurance Enrollment and Change Form (Form-1) with appropriate cancel coverage box(es) checked. For dental/vision, the employee completes the Dental/Vision (Form-1).
- If employee is withdrawing from health insurance and he/she has family coverage, the employee must provide proof of where spouse and/or dependents will be covered once GIC coverage is cancelled. Acceptable proof examples: a copy of the health insurance card or a letter from the spouse’s employer on their letterhead. Without this proof, the GIC can deny the request to withdraw from coverage.
- Verify that the employee has completed the forms accurately and completely.
- Review and sign Insurance Enrollment and Change Form (Form-1) and Dental/Vision (Form-1), if applicable.
- Enter change in MAGIC system.
- Photocopy Insurance Enrollment and Change Form (Form-1) and proof of other coverage (if applicable) and file in employee’s personnel file.
- Send original Insurance Enrollment and Change Form (Form-1) and Dental/Vision Form-1, if applicable, and proof of other coverage (if applicable) to the GIC.
- The GIC will mail to the insured’s home a HIPAA Notice that includes a Certificate of Creditable Coverage indicating the coverage end date.
This information provided by the Group Insurance Commission .
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