Member Enrollment
- 2024 LGHIP Health Enrollment Form (LG01)
- 2024 LGHIP Status Change Form (LG02)
- 2024 LGHIP Retiree Years of Service Verification Form (LG22)
- 2024 LGHIP New Dependent Form (LG02-B)
- 2024 LGHIP Dependent Cancellation Form (LG02-C)
- 2024 LGHIP Cancellation Form (LG03)
- 2024 LGHIP Declination of Coverage Form (LG04)
- 2024 LGHIP ACA Verification Form (LG23)
- 2024 Automatic Payments (COBRA) (LG14)