An employee must provide you with proof of involuntary loss of health coverage elsewhere to be eligible to enroll in GIC health coverage at any time during the year, other than during annual enrollment. An employee may not apply for late enrollment during their 60-day new hire waiting period. Examples of acceptable proof of loss of other coverage include:
- Letter from health insurance carrier on company letterhead, or
- Letter from other employer on company or organization letterhead.
To add GIC health coverage during the year, include a copy of the proof of involuntary loss of coverage with the forms sent to the GIC.
Health late enrollment procedure:
- Employee must complete the following forms completely and legibly:
- Municipal Insurance Enrollment and Change Form (Form-1MUN)
- Insurance Data Form (IDF) for family coverage. Must also provide:
- 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 or over – Dependent Age 19 to 26 Enrollment form and a copy of birth certificate or, for handicapped dependent coverage – Handicapped Dependent Application and a copy of birth certificate
- Verify that the forms are completed accurately and completely. Ensure that the employee has checked the information entered on his/her forms, and has signed and dated all forms.
- On the Municipal Insurance Enrollment and Change Form (Form-1MUN), indicate the agency/division number.
- Photocopy completed GIC forms and copy of proof of involuntary loss of coverage and file them in the employee’s personnel file.
- Send the original signed forms to the GIC along with the proof of involuntary loss of coverage.
Update your payroll system with the new premium deductions.
This information provided by the Group Insurance Commission.