Mfn.dps.louisiana.gov

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STATE OF LOUISIANA

WebFor each dependent, employee must check the box in section 3 if they wish that dependent to have health and/or life coverage. For life insurance, employee must also check the …

Actived: 5 days ago

URL: https://mfn.dps.louisiana.gov/docs/OGB_Enrollment_Change_Form.pdf

STATE OF LOUISIANA

WebIf the employee declines health coverage, he or she must acknowledge the offer of coverage by completing the GB-01 form. The acknowledgment must be sent to OGB and …

Category:  Health Go Health

State of Louisiana 2022 Office of Group Benefits

WebState of Louisiana . Office of Group Benefits - Flexible Benefits Plan Flexible Spending Arrangement Enrollment/Stop Form. GB-02 Revised 09/2021. You must complete this form

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New Health Insurance Marketplace Coverage Options

WebWhen key parts of the health care law take effect in 2014, there will be a new way to buy health insurance: the Health Insurance Marketplace. To assist you as you evaluate …

Category:  Health Go Health

HELP PROTECT YOUR LOVED ONE S— AND YOUR INCOME

WebSpouse & Children- Basic Dependent Term Life 100% Employee Paid n Purchase coverage for your spouse and children for either $1,000 for your spouse and $500 for your …

Category:  Health Go Health

State of Louisiana 2021 Office of Group Benefits

WebArrangement (FSA) Handbook before deciding on the amount. • In Box #1, indicate the dollar amount you elect to contribute for the plan year. • In Box #2, indicate the number …

Category:  Health Go Health

Louisiana Department of Public Safety: Management & Finance

WebHR contact information. Physical Address: 7979 Independence Blvd. Suite 201 Baton Rouge, LA 70806. Mailing Address: P.O. Box 66614 Baton Rouge, LA 70896-6614

Category:  Health Go Health

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