- Employee completes the Enrollment/Change Form (Form-1) checking off the deletion box and listing the dependent’s name, date of birth, relationship and Social Security Number and attaching documentation of qualifying status change.
- The employee must indicate the reason for the deletion and effective date (this date cannot be retroactive)
- Photocopy the form and file in the employee’s personnel file.
- Send the original form to the GIC within 60 days of the qualifying event. Forms received after 60 days are returned and the employee may re-apply during Annual Enrollment.
This information provided by the Group Insurance Commission .