Office of Group Benefits Forms and Office Locations – Government Agency in Louisiana

41 - 60 of 62 forms

Form Title	Topics
Health Equity Mistaken HSA Distribution Form
Health Equity Return Mistaken HSA Contribution Form
Health Savings Account (HSA) Transfer/Rollover Request Form
HIPAA Notice of Privacy Practices
Important Notice from the Office of Group Benefits (OGB) About Your Prescription Drug Coverage and Medicare
Important Notice from the Office of Group Benefits (OGB) About Your Prescription Drug Coverage and Medicare 2025
LaGov OGB Monthly Statement
Life Insurance Administrative Errors Form
Life Insurance Administrative Errors Form
LSU Grandfathered Employees AD&D Coverage
Non-Instructional Staff of the Ouachita Parish School Board Certificate of Coverage
Non-LaGov OGB Monthly Statement
Notice of Group Life Conversion Privilege
OGB Bariatric Services Enrollment Form
Portability Election
Portability Rates
Preferential Beneficiary’s Statement
Prudential Life Beneficiary Designation/Change
Prudential Life EOI – Agency Instructions
Prudential Life Evidence of Insurability Form (EOI)

Office of Group Benefits