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Get Gic Form 1a
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How to fill out the Gic Form 1a online
Filling out the Gic Form 1a online can streamline the process of reporting employment status changes. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.
Follow the steps to complete Gic Form 1a online
- Click the ‘Get Form’ button to access the Gic Form 1a and open it in your preferred online document editor.
- Enter your insured information at the top section of the form. This includes your GIC ID, last name, first name, street address, city, state, zip code, phone numbers, and email. Ensure that all fields are filled out completely.
- Fill in your date of birth, date of hire, and number of work hours per week. This information is critical for GIC’s records.
- Indicate your leave of absence status by selecting either 'Leave with pay' or 'Leave without pay' as applicable. If you select leave without pay, you may need to provide documentation for certain types of leave.
- Complete the section for transfers and termination by detailing the name of the agency you’re transferring to or from, dates related to your employment change, and termination reason if applicable.
- For retirement, indicate your retirement date and check the appropriate box if you wish to enroll in Medicare. If you have optional life insurance, adjust any elected coverage as needed.
- Sign and date the form at the bottom. An authorized official's signature is also required if applicable.
- After completing the form, save any changes, and download or print a copy for your records. Ensure you submit the form as directed for processing.
Complete your Gic Form 1a online today to ensure your employment status change is processed without delay.
You can continue coverage into retirement if you retire within 120 days of your separation date. You can enroll in the CalPERS Health Program if your employer contracts for it and you meet the eligibility requirements. You may also be eligible for Dental & Vision Benefits. Health equity starts with you.
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