Get the free GIC MUNICIPAL ENROLLMENT/CHANGE FORM ... - Mass.gov

GIG MUNICIPAL ENROLLMENT/CHANGE FORM (FORM1MUN) Health Insurance INSURED INFORMATIONREQUIREDGICID (usually Soc. Sec. #) Sex Insured Information Name Classmate of Birth /FFirstMIStreetAddressDept.

How to fill out gic municipal enrollmentchange form

How to fill out gic municipal enrollmentchange form

1. To fill out the GIC municipal enrollment change form, follow these steps:
2. Download the GIC municipal enrollment change form from the official GIC website or collect a hard copy from your local GIC office.
3. Start by entering your personal information such as your name, address, date of birth, and contact details in the designated fields.
4. Provide your current municipal enrollment information, including the name of the municipality you are enrolled in and your enrollment number.
5. Specify the changes you want to make to your enrollment. Whether you want to update your address, change your municipality, or modify any other relevant details, clearly state them in the form.
6. If there are any supporting documents required, make sure to attach them along with the form. These documents could include proof of address, identification documents, or any other necessary paperwork.
7. Double-check all the information you have provided to ensure accuracy and completeness.
8. Once you have filled out the form and attached all required documents, submit it to the GIC office either in person or through mail as per their specified instructions.
9. Keep a copy of the filled form and any supporting documents for your records.
10. Wait for the GIC to process your enrollment change request. You may receive a confirmation or further communication from them regarding the status of your request.
11. If you have any questions or need assistance, contact the GIC helpline or visit their website for more information.

Who needs gic municipal enrollmentchange form?

1. Anyone who is currently enrolled in a municipal program under the GIC and needs to make changes to their enrollment information or update their details should fill out the GIC municipal enrollment change form. This form is for individuals who wish to modify their address, switch municipalities, or make any other relevant changes to their existing enrollment. It is important to accurately complete this form in order to ensure the updated information is properly reflected in the GIC's records.

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What is gic municipal enrollment change form?

The GIC Municipal Enrollment Change Form is a document used by municipalities to enroll or change the enrollment status of employees in the Group Insurance Commission (GIC) health insurance program.

Who is required to file gic municipal enrollment change form?

Municipalities and their employees, including new hires or employees changing their insurance status, are required to file the GIC Municipal Enrollment Change Form.

How to fill out gic municipal enrollment change form?

To fill out the GIC Municipal Enrollment Change Form, a municipality should enter the employee's details, select the insurance plan, indicate any changes in enrollment, and provide the required signatures.

What is the purpose of gic municipal enrollment change form?

The purpose of the GIC Municipal Enrollment Change Form is to officially document changes in health insurance enrollment and ensure that employees have the appropriate coverage under the GIC.

What information must be reported on gic municipal enrollment change form?

The form must report the employee's name, address, date of birth, social security number, the changes being made to their enrollment, and the type of insurance plan selected.