Get the free massgov gic idf form - umassmed

INSURANCE DATA FORM (IDF) PLEASE TYPE OR PRINT CLEARLY P.O. Box 8747 BOSTON, MA 02114-8747 (617) 727-2310 www.mass.gov/gic This form is required for new enrollments in any Group Insurance Commission

How to fill out massgov gic idf form

How to fill out the massgov gic idf form:

1. Download the form from the official massgov website or obtain a physical copy.
2. Read and understand the instructions provided with the form.
3. Fill in your personal information such as name, address, and contact details in the designated fields.
4. Provide the necessary information about your current health insurance coverage, including policy details and the name of the insurance provider.
5. Specify any dependents or family members who are also covered under the insurance plan.
6. Provide information about your annual income and any financial assistance you may be receiving.
7. Review the completed form to ensure that all required fields are filled accurately and completely.
8. Sign and date the form.
9. Submit the form according to the instructions provided, either by mailing it or submitting it online if available.

Who needs the massgov gic idf form:

1. Employees of the Massachusetts state government who are eligible for the Group Insurance Commission (GIC) health insurance plans.
2. Retirees and survivors who are receiving health insurance coverage through the GIC.
3. Individuals who wish to enroll in or make changes to their health insurance coverage through the GIC.

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What is massgov gic idf form?

Massgov GIC IDF form is a form used by employers in Massachusetts to report information about their employees' health insurance coverage.

Who is required to file massgov gic idf form?

Employers in Massachusetts who provide health insurance coverage to their employees are required to file the Massgov GIC IDF form.

How to fill out massgov gic idf form?

To fill out the Massgov GIC IDF form, employers need to provide information about their company, employees, and health insurance coverage. The form can be filled out online or submitted by mail.

What is the purpose of massgov gic idf form?

The purpose of the Massgov GIC IDF form is to collect information about employee health insurance coverage in Massachusetts. This information is used by the state to administer the Group Insurance Commission program.

What information must be reported on massgov gic idf form?

The Massgov GIC IDF form requires employers to report information such as their company name and address, the number of employees who are offered health insurance, and details about the health insurance plans offered.