EMPLOYER INFORMATION RESOURCES
POLICIES, DOCUMENTS AND FORMS
- Administrative Guide
- Administrative Letters
- Benefits Eligibility Acknowledgement Form (English)
- Benefits Eligibility Acknowledgement Form (Español)
- Benefits Eligibility Acknowledgement Form - Waiving Benefits
- Benefits Eligibility Acknowledgement Form - Waiving Benefits (Español)
- COBRA Notification to Term Benefits
- RMD Current Year Refund Request (Employee)
- RMD Current Year Refund Request (Employer)
- DFA Summary Page (Download)
- Disability Policy
- Domestic Partnership Form
- Employee Enrollment Resources
- LWOP Benefit Premium Transmittal Form
- Notification to Terminate Benefits Due to Non-Payment of Premiums
- POP Waiver Form (State)
- PREMIUM RATE SHEETS – STATE
- RMD Prior Calendar Year Refund Request Form (Employee)
- RMD Prior Calendar Year Refund Request Form (Agency)
- W-9 Form Instructions
- W-9 New Form
- Premium Payment OPR Transmittal
LPB FORMS
NOTICES, RESOURCES AND INFORMATION
- Benefits Comparison Guide 2021
- Benefits Comparison Guide 2022
- Benefits Information
- Benefit Plan Contacts
- Benefits Premium Calculator
- COBRA Resources Page
- Disability Resources Page
- Federal Medicare Part D Creditable Coverage Notices
- HIPAA Privacy Notice
- HR Meetings and Recordings
- Newsletter Archive
- SHARE Self Service Instruction Guide
- Trifold Benefits Brochure