If a municipal employee or retiree who has coverage through the GIC dies, his/her surviving spouse is eligible for GIC health insurance coverage until he/she remarries or dies. The surviving spouse must apply for survivor spouse coverage as it is not an automatic benefit:
  • Instruct the employee/survivor to complete the Municipality Insurance Enrollment and change Form (Form - 1MUN), indicating that the person is a Survivor.
  • Attach a copy of the death certificate to the Form-1MUN.
  • If the survivor wishes to cover a dependent age 19 or over, he/she must include a completed Insurance Data Form (IDF). If adding dependents to this coverage, the following documentation is required:
    • For dependent coverage under age 19 - copy of birth certificate(s) - the GIC must be able to link dependent to insured or surviving spouse.
    • For dependent age 19 or over - Dependent Age 19 to 26 Enrollment Application and a copy of birth certificate
  • Verify that the forms above are completed accurately and completely. Ensure that both you and the survivor have signed and dated all forms.
  • 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 .