Attn: Human Resources
Central Administration Building
146 Maple Street
Lexington, MA 02420
If you have any questions relating to any of these materials, please call us at (781) 861-2580
Forms and Information concerning your Employee Benefits
GIC Health Information and Enrollment Forms
(if you are enrolling in health and/or dental insurance, you will need to produce a government-issued marriage certificate for your spouse and birth certificates for any dependents to be covered)
GIC – 1MUN Enrollment/Change Form
GIC – Dependent Age 19-26 Enrollment/Change Form
For changes to your current health insurance plan, you now have the convenience
of submitting documents electronically through MyGICLink. The GIC website can be accessed at: MyGICLink
If you are eligible for GIC Health Insurance and you enroll in our health insurance, please read the information regarding the Health Reimbursement Account (HRA). Existing employees may have the opportunity to Opt-Out. Please read the information below.
Other Benefit Forms/Information
- Delta Dental Plan Descriptions
- Dental Rate Sheet
- Delta Dental Enrollment/Change Form
- EyeMed Info
- EyeMed Rate Sheet
- EyeMed Enrollment Form
- FSA Enrollment Form
- Basic Life Insurance Benefits Summary
- Life Insurance Basic & Optional Rates
- Life Insurance Basic and Optional Enrollment Form
- Life Insurance Beneficiary Change Form
- Evidence of Insurability Form To be completed only if making change after original eligibility
- 403b Plan
- 457 Plan – Massachusetts Deferred Compensation SMART Plan
- MA Health Connector Information (for review by non-benefit’s eligible staff)
General Information and Forms: