The Office of Group Benefits (OGB) requires participating agencies to appoint employees as contacts between the agency and OGB. The forms to designate those contacts can be found below. In addition, agencies will find forms for life insurance eligibility, continuation of coverage for a handicapped child, HSA deduction submission and years of participation calculation. If you have questions about a particular form or need assistance, contact OGB Customer Service at 1-844-860-0307.

2024 GB-02 Flexible Spending Arrangement Enrollment\Stop Form
	New employees wishing to enroll in a Flexible Spending Arrangement complete this form and return to their HR department within 30 days of their hire date. This form can also be used for an enrollee experiencing a qualifying event and needs to make a change to his/her coverage or enrolling in an FSA during the annual enrollment period.