• Enrollment & Change Form (GIC Form 1)

    For enrolling, changing coverage and/or canceling coverage for basic life and health insurance; optional life insurance; and long term disability insurance. Use for name or address change, leave of absence, return to payroll, retirement, agency transfer and termination.

  • Insurance Data Form (IDF) links to PDF file

    This form is required for new enrollments in any Group Insurance Commission family health plan and for any changes in spouse or dependents.

  • Life insurance beneficiary form

    Contact your agency's GIC coordinator.

  • Group Insurance Commission (GIC) Customer Forms

    All relevant forms for each type of GIC customer

  • Additional Status Change Forms

    GIC forms for leaving state service, leave of absence, student coverage and more.