NV.gov
Eligibility Forms and Notices for All Plans
- Health Insurance Marketplace Coverage Options to Your Health Care Coverage Notice (Agency Representatives)
- HIPAA Special Enrollment Rights (Agency Representatives) Notice
- Certification of Disabled Dependent Child
- Guardianship to Age 26 Certification Form
- Release of Information Authorization
- Retiree Benefit Enrollment and Change Form
- Years of Service Form
- Benefit Enrollment and Change Form Unsubsidized
- Travel Pre-Authorization Form
- Travel Reimbursement Form
- SSN Questionnaire