- 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.
- 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 formContact your agency's GIC coordinator.
- All relevant forms for each type of GIC customer
- GIC forms for leaving state service, leave of absence, student coverage and more.