If an employee is changing from family to individual coverage, follow the procedures below.

  1. The employee must complete and sign the following: GIC Municipal Insurance Enrollment and Change Form (Form-1MUN).  The employee must provide proof of where the spouse and/or dependents will be covered for health insurance before the changes will be allowed.  Acceptable proof of other coverage for the spouse and/or dependents includes a copy of other health insurance card or a letter from the spouse’s employer on their letterhead. Without this proof the GIC can deny the request for coverage change.  In the case of death, a copy of the death certificate is required.
  2. Verify that the form is completed accurately and completely.  Ensure that both you and the employee have signed and dated the form.
  3. Update your payroll system with the new premium deduction.
  4. Photocopy completed GIC form and proof of other coverage and file them in the employee’s personnel file
  5. Send original signed form to the GIC along with the proof of other coverage.

This information provided by the Group Insurance Commission.