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  • Group Benefits E-application For Change

Get Group Benefits E-application For Change

Group Benefits eApplication for Change Please print clearly and complete all pages of form. If required, retain a photocopy for your files. 1 General information Plan contract number(s) Plan member.

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The Office of Group Benefits (OGB) is an agency of the State of Louisiana within the Division of Administration (DOA). It is authorized by state statute to provide health and life insurance benefits to eligible employees and retirees of participating agencies, as well as their eligible dependents.

Go to your Manulife CoverMe® (including Flexcare® and FollowMe®) SecureServe® sign-in page. It's the same for your alumni, professional or retail group (i.e., OMA, , CAA), to submit a health/dental claim, or to review your coverage.

Change your beneficiary Sign in to your plan on the website. Click on the Group Benefits tile, then click “Go” under the plan you want to access. Under “Forms,” click “Administration Forms – Find a form – Change of Beneficiary” Complete the form and submit it as per the instructions on the form.

As a new user, enter your name, date of birth, and email. You'll need to pick a unique username and password. Click Continue. Note: If you see the below screen, you may have already created. a Manulife ID. If you remember your username, click Sign in. If. Forgot username.

Once you've registered on the site, you can submit your form online: Step 1—Find the right form and fill it out. Step 2—Sign in to your account online. Step 3—Go to “My account” then click “Send documents”.

Submit your claim online: Within 12 months of the date you were charged. After you've paid more than any deductible in your plan. Specify the currency if your claim is for services outside Canada. Hold onto receipts and applicable supporting documentation for 12 months.

Once you've signed in, choose “Contact us”. And then “Send documents”. Then you upload the document you want to send to us. You can attach a PDF or even a picture of a document.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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