GIC RMT ENROLLMENT FORM (FORM-RMT) - Mass 2026

1. Click ‘Get Form’ to open the GIC RMT ENROLLMENT FORM in our editor.
2. Begin by filling out the 'Insured Information' section. Enter your GIC-ID, name, address, date of birth, and contact information. Ensure all required fields are completed accurately.
3. Proceed to the 'Retirement Information' section. Indicate whether you will receive a monthly pension from a public retirement system and provide your retirement date.
4. Select your health plan options under 'MEDICARE PLAN' or 'NON-MEDICARE PLAN' based on your eligibility. Check all applicable boxes for Medicare coverage.
5. In the 'SPOUSE/DEPENDENT INFORMATION' section, add or drop dependents as necessary. Fill in their last names, dates of birth, and relationships.
6. Complete the 'FORMER SPOUSE INFORMATION' if applicable, including divorce dates and remarriage status.
7. Sign and date the authorization section at the end of the form to confirm your selections and understanding of coverage requirements.

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