Forms

Forms must be completed and submitted to the GGUSD Insurance Dept. to process any change to your coverage for yourself and/or your dependents. See forms below to be completed for enrollment or common changes; original signature required; must be received within 30 days of the qualifying event. For new hires, forms must be received within 30 days of the first day of work. Additional proof of eligibility may be required. *If there is no qualifying event, you cannot add/remove yourself and/or your dependents outside of Open Enrollment (mo. of Oct., effective Jan. 1). Please contact the Insurance Department with any questions: (714) 663-6523.

Initial Enrollment

Adding or Removing a Dependent

Waiving Benefits

Optional FSA