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STATE OF LOUISIANA OFFICE OF GROUP BENEFITS ENROLLMENT/CHANGE FORM (Page 1 of 2) Agency NumberAgency Preprimary Plan Participant/Employee Name Date of Resection 1 Primary Plan Participant/ Employee
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For state employees is a form that needs to be filled out by employees working for the state government.
All state employees are required to file the form for state employees.
State employees can fill out the form for state employees either online or through a paper form provided by their employer.
The purpose of the form for state employees is to track and report information about state employees for tax and administrative purposes.
The form for state employees typically requires information such as income, deductions, and any benefits received by the employee.
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