All GIC-eligible employees must be given a Children's Health Insurance Program (CHIP) Notice each Annual Enrollment to let them know about how to access premium assistance if they or their children are eligible for Medicaid or CHIP.

If an employee is not currently enrolled in GIC coverage and wants to do so, complete the following and send to the GIC during by the enrollment period:

BASIC LIFE ONLY ENROLLMENT

Employees who want to enroll in Basic Life insurance must do so within 10 days of hire.  After this initial eligibility period, employees wishing to enroll may do so only during Annual Enrollment.  To enroll during Annual Enrollment:

  1. Instruct the employee to complete and sign Enrollment/Change Form (Form-1) and Life Insurance Beneficiary Form-319 (one to three beneficiaries) or Life Insurance Beneficiary Form G-500 (four or more beneficiaries or special designations e.g. estate and trust).
  2. Review the Enrollment/Change Form (Form-1) for completeness and be sure that the date of hire and annual salary are completed before signing the form.
  3. Enter the Basic Life premium deduction into your payroll system.
  4. Photocopy completed forms and file them in the employee’s personnel file.
  5. Send the original Enrollment/Change Form (Form-1) and Life Insurance Beneficiary form to the GIC by the Annual Enrollment deadline.

LIFE AND HEALTH INSURANCE ENROLLMENT

If an employee is not currently enrolled in GIC life and health insurance coverage, complete the following to enroll during Annual Enrollment: 

  1. To select basic life and health benefits, employees must complete the following forms completely and legibly.
    • Enrollment/Change Form (Form-1 )
        • 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 certificates 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.  For a handicapped dependent, a Handicapped Dependent Application and copy of birth certificate.  The birth certificates must show the parent-child relationship to the insured or his/her spouse.
    • Life Insurance Beneficiary Form-319 (one to three beneficiaries) or Life Insurance Beneficiary Form G-500 (four or more beneficiaries or special designations e.g. estate and trust).
  2. Verify that the forms above 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.
  3. On the Enrollment/Change Form (Form-1), indicate the Employee's annual salary and Effective date.
  4. Enter Basic Life and Health Insurance payroll deduction into your payroll system.
  5. Photocopy completed GIC forms and file them in the employee’s personnel file. 
  6. Send all original signed forms to the GIC by the Annual Enrollment deadline.
  7. If electing Optional Life Insurance, the GIC will notify the life insurance carrier, which will send the employee Evidence of Insurability (EOI) Application instructions.  If the employee does not complete the Evidence of Insurability by the due date indicated, his/her file will be closed.
  8. If the EOI application is approved, the GIC will advise you and the employee.  If approved, update your payroll with the new premium deduction. If the EOI application is denied, the life insurance carrier will notify the employee directly with the reason of denial.

This information provided by the Group Insurance Commission .

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