LSU First -- The LSU System Health Plan

Forms

  1. Beneficiary Designation Form for Term Life Insurance (7/1/2009-6/30/2010)
  2. Critical Illness Direct Cash Benefit Claim Form
  3. Death Claim for Term Life Insurance (7/1/2009-6/30/2010)
  4. Death Claim for Term Life Insurance (7/1/2008-6/30/2009) :: W-9
  5. Guide to CIGNA’s Explanation of Benefits (EOBs)
  6. Life Insurance Conversion Form
  7. Medical Claim Form (CIGNA)
  8. Personal Representative Form (CIGNA)
  9. Physician Nomination Form (CIGNA)
  10. Prescription Drug Claim Form (ESI)
  11. Student Verification Form