Forms must be completed and submitted to the GGUSD Insurance Dept. to process any change to your coverage for yourself and/or your dependents. *You must have a qualifying event to add / remove yourself and / or your dependents outside of Open Enrollment (mo. of Oct., effective Jan. 1). See forms below to be completed for enrollment or common changes; original signature required; must be received within 31 days of the qualifying event.

An additional 31 days from the effective date is afforded for you to provide a copy of your recorded marriage certificate or registration of domestic partnership and birth certificates for your children.

When newly married, an updated Life Insurance Beneficiary Designation form must be submitted.

Please contact the Insurance Department with any questions.

Initial Enrollment 
(Forms 1-3 are mandatory; also include forms 4 or 5 IF you choose either HMO plan)

Adding or Removing a Dependent:

Waiving Benefits

Miscellaneous Forms