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) LPB Waiver Form Template

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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