Benefits |
Websites for Benefits Providers |
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LASERS Forms |
01-06 Designation of Beneficiary |
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01-01 Membership Registration
*Upon completion by the employee, this
form must be forwarded to the Human Resources Division for
certification. |
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01-13 Benefit Forfeiture |
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LA Deferred
Compensation
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Deferred Compensation Benefits |
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Online Enrollment Procedures |
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Office of Group Benefits
Forms |
2022 Flexible Benefits Enrollment Form |
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Flexible Benefits Plan |
webpage
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Options for Health Insurance Coverage (Affordable Care Act) Notice |
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Affordable Care Act Acknowledgement Form |
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2022 OGB Medical Benefits Comparison for Active Employees and Non-Medicare Retirees |
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January 2022 Premium Rates |
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GB-01 Enrollment Change Form |
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HSA Payroll Election Form (GB-79) |
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Life Insurance Beneficiary Change Form |
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Life Insurance Enrollment Kit |
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