Benefit Specialists

This section is forms and information for the Human Resource Benefits Specialist at each agency or employer who is covered by Employees' Group Insurance benefits.

Benefit Specialist Forms

Revised 2016.
This form must be downloaded to activate the interactive fields.  CLICK on DOWNLOAD once this form has been opened in Google Chrome.
Used for when employee will be on long term deployment and must elect to keep or drop benefits.
Use for Military Deployed who pay for premium from checking account.
Used for Flex Direct Deposit.

Contact Us

Emerson Building
2001 Capitol Ave. Rm. B3
Cheyenne, Wy   82002
Telephone: (307) 777-6835 or (800) 891-9241 in WY
FAX: (307) 777-7685

Office hours are 8:00 am to 5:00 pm, Monday through Friday except holidays.