Enrollment



 
NEW HIRE OR CHANGE DUE TO QUALIFYING EVENT

If you are a new hire or have a qualifying event, and are making a change to your coverage that takes effect on or after January 1st, 2018 please use the 2018 LPB and Legislator Enrollment forms:
Legislator Enrollment Form (click here).
LPB Enrollment Form (click here).
 
 
  Legislators are not eligible for disability.

PREMIUM ONLY PLAN (POP) WAIVER
 
Premium Only Plan (POP) Waiver Form

POP Pre-tax premium deductions are automatic. Waiver form must be completed and submitted with benefits enrollment/change form IF you want post-tax deductions.
 
 
Please note that legislators are not eligible for POP.

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