If the employee is changing from individual to family coverage, follow the procedures below.
The employee must complete and sign the following:
For health insurance:
- GIC Insurance Enrollment and Change (Form-1)
- Insurance Data Form (IDF)
- For spousal coverage – copy of marriage certificate. (Note: Due to differences between federal and state law, if an insured is adding a same-sex spouse, the insured is subject to imputed income. Please advise the employee accordingly.)
- 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 age 19 to 26 – Dependent Age 19 to 26 Enrollment and Change Form and a copy of birth certificate. For a handicapped dependent, a Handicapped Dependent Application and a copy of birth certificate. The birth certificate must show parent-child relationship to the insured or his/her spouse.
- Beneficiary Designation Form (Form 319 or G-500) – if requesting a change
A few of the GIC’s offline agencies are eligible for GIC Dental/Vision. See the Dental/Vision Eligibility Section for details.
- Dental and Vision Enrollment and Change form – See Dental/Vision section for eligibility. If family coverage is not elected for health insurance, but the employee wishes to have dental/vision coverage, he/she must also submit copies of the documents listed under the Insurance Data Form (IDF) above.
For all changes:
- Verify that the forms above are completed accurately and completely. Ensure that both you and the employee have signed and dated all forms.
- Update your payroll system with the new premium deductions.
- 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 .