GIC COORDINATOR, AGENCY HEAD, OR ADDRESS CHANGE

Please be sure to notify the GIC of GIC Coordinator and Agency Head name, e-mail, and/or address changes. This will ensure that the agency continues to receive GIC materials and updates. Send an email to GIC Coordinator Changes and be sure to include your agency/division number, agency/municipal name, and address.  Or, mail the Agency Contact Form doc format of agency_update_form_for_Coordinators.doc
to the GIC. extension 2.

The GIC sends all GIC Coordinators the following reports on a monthly basis.  Be sure to follow the following procedures:

Monthly Insurance Billing Report (MIBR) GIC Reports and Reconciliation Process

The GIC sends all GIC coordiators the following report on a monthly basis.  Be sure to follow the procedures.

These reports are an alphabetical list of employees by agency, who are insured with the Group Insurance Commission for the Basic Life, Health, and Optional Life Insurance coverage. 

You may receive up to three monthly insurance billing reports:

  • Health and Life coverage for employees on deduction and/or direct bill
  • Dental/Vision for employees on deduction and/or direct bill (or Retiree Dental Report for Retiree/Survivor Agencies)
  • LTD for employees on deduction and/or direct bill

Each month, review and verify the following information shown on the report:

  • Names for all insureds should agree with your agency’s records.
  • Coverage for each insured should agree with your agency’s records.
  • The premium due for each insured should agree with your agency’s records.

If the Agency has discrepancies with the GIC report, complete the following:

1) If the Monthly Insurance Acknowledgement Report contains incorrect GIC-ID numbers, names, coverage, or premium due GIC, indicate these discrepancies on the Statement of Verification (discrepancy report) with the following information:

    • The agency/division number (as it appears on the report)
    • The premium due month
    • Check off box “Discrepancies are as listed”
    • GIC ID number as it appears on the report
    • Employee’s name (last, first, middle initial)
    • Premium Amount discrepancy, if applicable
    • Explanation of discrepancy:
      • Briefly describes the discrepancy.
      • Include the date and reason for all terminations of insurance coverage.
      • Include the retirement date for an employee who has retired.
      • For an employee who is on a leave of absence without pay, include the duration of leave (with start and end dates) and reason for leave.
    • Important! REQUIRED - Complete the Grand Total, Combined Total of Discrepancies, and New Total section of the Statement of Verification.
    • Signature of Authorized Official and Date

2) Photocopy the Statement of Verification for your agency file.

3) Send the original Statement of Verification along with the payment for your Enrollee's share of the premium to the Group Insurance Commission by the date requested.

If the Agency does not have discrepancies with the GIC report, complete the following:

  1. If the Monthly Insurance Billing Report contains no discrepancies, send the Statement of Verification (discrepancy report) to the Group Insurance Commission with the following information:
    • The agency/division number
    • The premium due month
    • Check off box “Agency has no discrepancies”
    • Important! REQUIRED - Complete the Grand Total, Combined Total of Discrepancies, and New Total section of the Statement of Verification.
    • Signature of Authorized Official and Date
  2. Photocopy the Statement of Verification for your agency file.
  3. Send the original Statement of Verification or the Total Amount Due, along with the payment for your Enrollee's share of premium to the Group Insurance Commission by the date requested.

This information provided by the Group Insurance Commission .

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