State of New Mexico | Group Benefits Plan
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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)
Death Claim Form
DFA Summary Page (Download)
Disability Policy
Disability Calculation Sheet (Download)
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
NOTICES, RESOURCES AND INFORMATION
Benefits Comparison Guide 2021
Benefits Comparison Guide 2022
Benefits Information
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Benefits Premium Calculator
COBRA Resources Page
Disability Resources Page
Federal Medicare Part D Creditable Coverage Notices
HIPAA Privacy Notice
HR Meetings and Recordings
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SHARE Self Service Instruction Guide
Trifold Benefits Brochure
LPB FORMS
LPB Employee Change/Correction Form
POP Waiver Form (LPB)
Premium Rates Sheets – LPB
