Updated April 9, 2014

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:

  1. Instruct the employee to complete and sign Insurance Enrollment and Change Form (Form-1) and Beneficiary Designation Form 319 (one to three beneficiaries) or Nomination of Beneficiary form G-500 (four or more beneficiaries or special designations e.g. estate and trust).
  2. Review the form for completeness and complete the agency section 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 GIC forms and file them in the employee’s personnel file.
  5. Send the original Insurance Enrollment and Change Form (Form-1) and 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.
    • Insurance Enrollment and Change Form -Form 1
    • Beneficiary Designation Form 319 (one to three beneficiaries) or Nomination of Beneficiary form G-500 (four or more beneficiaries or special designations e.g. estate and trust).
    • 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 GIC must be able to link dependent to insured or spouse. ). 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.
  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. Be sure to indicate the date of hire and annual salary.
  3. Enter life and health insurance deductions into your payroll system.
  4. Photocopy completed GIC forms and file them in the employee’s personnel file. 
  5. Send all other original signed forms to the GIC.
  6. If the employee has also elected optional life insurance, the GIC will notify the life insurance carrier to send the employee a Medical Evidence of Insurability Application to complete and return.  If the employee does not respond to the medical evidence of insurability, their file will be closed. 
  7. If the medical application is approved, the GIC will advise you and the employee.  At this time, update your payroll system with the new optional life payroll deduction.

The employee should be automatically enrolled in pre-tax health insurance deductions unless he/she opts out of participating. This is known as a Section 125 Plan.


This information provided by the Group Insurance Commission .