LEHB FORMS

FORMS-GUIDES
Below is a list of LEHB's most commonly requested forms and guides. You may print out a blank form from from this page by clicking on the corresponding download button below.
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    How To Add Or Remove Dependents

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    Add Or Remove a Dependent Form

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    Blue Cross/Shield Benefits Summary

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    Change of Address Form

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    Dental Providers

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    Express Scripts

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    Fitness Logbook

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    Fitness Reimbursement Booklet

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    Programs and Services Guide

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    Smoking Cessation Resources

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    Vision Participant Notice

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    Vision Claim Form

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    Vision Care Providers