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Form LG08
Revised 8/23LOCAL GOVERNMENT HEALTH INSURANCE PROGRAM
CHANGE FORM
SOUTHLAND VOLUNTARY INSURANCEPARTICIPANT INFORMATION (Please print or type.)
Name (First, Middle Initial, Last)Social Security
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What is peehip new enrollment?
PEEHIP new enrollment refers to the process of registering for the Public Education Employees' Health Insurance Plan for the first time or making changes to your existing coverage.
Who is required to file peehip new enrollment?
Employees of public education institutions in Alabama who wish to enroll in the PEEHIP program or make changes to their existing insurance must complete a new enrollment form.
How to fill out peehip new enrollment?
To fill out a PEEHIP new enrollment form, gather required personal information, select your plan options, and ensure all sections of the form are completed accurately before submission.
What is the purpose of peehip new enrollment?
The purpose of PEEHIP new enrollment is to allow eligible employees to obtain health insurance coverage and to manage their health plan selections based on their needs.
What information must be reported on peehip new enrollment?
The information that must be reported includes personal identification details, employment information, coverage selections, and any dependents you wish to enroll.
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