POP Waiver Form (State Employee)
Form for state employees to opt out of pre-tax premium deductions.
Premium Only Plan (POP) Waiver Forms
Information and forms for opting out of pre-tax premium deductions.
State Employees
POP Pre-tax premium deductions are automatic. Waiver form must be completed and faxed to Erisa at (505) 244-6009 the same day that you submit your online enrollment/change form if you want post-tax deductions.
LPB Employees
POP pre-tax premium deductions are automatic. Waiver form must be completed and submitted to your employer if you want post-tax deductions.
Legislators
Please note that Legislators are not eligible for POP.
POP Waiver Forms
Download the appropriate waiver form for your employee type.
POP Waiver Form (LPB Employee)
Form for LPB employees to opt out of pre-tax premium deductions.