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State of New Mexico | Group Benefits Plan

Premium Only Plan (POP) Waiver Forms

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 Form (State Employee)

POP Waiver Form (LPB Employee)