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STATE OF LOUISIANA - OFFICE OF GROUP BENEFITS - ENROLLMENT/CHANGE FORM AGENCY NUMBER AGENCY NAME DATE OF HIRE ANNUAL SALARY EMPLOYEE NAME CHANGED TO PURPOSE ? Waiver of Coverage ? Annual Enrollment.

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Contact support

You can reach OGB Customer Service by email at OGB.CustomerService@la.gov or by phone at 1-800-272-8451.

Group insurance plans are purchased by organizations and provided as employee benefits.

The difference between the Local and Local Plus is the network of providers. Out-of-network coverage is in emergencies only for both plans. *There is no out-of-network coverage except in emergencies. Eligible services are covered at 100% after the applicable co-payment and/or deductible is met.

What are group benefits? Group benefits refer to the different insurance types that cover a group of people, such as the employees in a business. In addition to medical insurance, group benefits can also include ancillary benefits like the insurance options offered by Guardian.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232