Form SGLV 8285A, Request for Family Coverage, has been replaced with the redesigned SGLV 8286A, Family Coverage Election and Certificate. Follow this link to download the new form.
8286A, Family Coverage Election and Certificate
The form is in PDF format, readable with the Adobe Reader version 7.0 and above. You can download the Adobe Reader for free by following this link to the Adobe Website.
To view the form, either left-click on the link above to look at the form in your browser, or right-click on the link and choose "Save Target As" or "Save Link As" in the sub-menu.
Reviewed/Updated Date: November 1, 2012