MEMBER FORMS ARCHIVE
Occasionally a member may need to make a change to their benefits, appeal a claim denial, submit a claim, etc. Members will find the necessary forms to complete those actions and others below. If you have questions about a particular form or you are not sure which form you need, contact OGB Customer Service at 1-800-272-8451.
|
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. |