HEALTH INSURANCE

An employee must provide you with documentation of qualifying status change event to be eligible to enroll in GIC health coverage during the year, other than during Annual Enrollment.  An employee may not apply for late enrollment during his/her new hire waiting period.  Forms and required documentation must be received at the GIC within 60 days of the qualifying status change event.  Otherwise the employee must wait until the next Annual Enrollment to enroll.

Health insurance late enrollment procedure:

  1. 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/Change Form  For handicapped dependent coverage – Handicapped Dependent Application..  Accompanying birth certificates must show parent-child relationship to the insured or his/her spouse.
  2. Verify that the form is completed accurately and completely. Ensure that the employee has entered all information completely including the date of hire, and has signed and dated all forms.
  3. On the Municipal Insurance Enrollment and Change Form (Form-1MUN), indicate the agency/division number.
  4. Photocopy completed GIC form and documentation of qualifying status change event and file them in the employee’s personnel file.
  5. Send the original signed forms and documentation to the GIC within 60 days of the qualifying status change event.  Forms and documentation received after 60 days are returned and the employee may re-apply during Annual Enrollment.
  6. If the GIC approves the late enrollment, we will advise you of the effective date.
  7. If approved by the GIC, update your payroll system with the new premium deduction.

GIC RETIREE DENTAL

If your municipality offers the GIC Retiree Dental Plan, a retiree or survivor must apply for coverage within 60 days of a qualifying status change event.

Advise the retiree or survivor who is applying for late enrollment that once enrolled, if he/she drops coverage, he/she may never re-enroll in the plan.

Procedure:

  1. Retiree or survivor completes and sends you the GIC Municipal Retiree Dental Enrollment/Change Form (Form-MRD) and documentation of the qualifying status change event.
  2. Sign the GIC Retiree Dental Plan form.
  3. Photocopy the GIC Municipal Retiree Dental Enrollment/Change Form (Form-MRD) and documentation of the qualifying status change event and file in the retired employee’s personnel file.
  4. Send the original GIC Municipal Retiree Dental Enrollment/Change Form (Form-MRD) and documentation of the qualifying status change within 60 days of the qualifying status change event to the GIC.  Forms and documentation received after 60 days of the qualifying status change event will be returned and the retiree may re-apply during Annual Enrollment.
  5. Approval of the late enrollment and the effective date will be determined by the GIC.
  6. If approved, the GIC will notify you of the effective date to start the pension deduction.

This information provided by the Group Insurance Commission .