Member Enrollment
- 2025 LGHIP Health Enrollment Form (LG01)
- 2025 LGHIP Status Change Form (LG02)
- 2025 LGHIP Retiree Coverage Enrollment Form (LG22)
- 2025 LGHIP New Dependent Form (LG02-B)
- 2025 LGHIP Dependent Cancellation Form (LG02-C)
- 2025 LGHIP Cancellation Form (LG03)
- 2025 LGHIP Declination of Coverage Form (LG04)
- 2025 LGHIP ACA Verification Form (LG23)
- 2025 Automatic Payments (COBRA) (LG14)
