You will need the forms that start with a plus sign (+) to process new business.
- + LIA HA Employer New Business Agreement
- + LIA HA New Business Checklist
- + LIA HA New Business Enrollment or Change Form Downstate
- + LIA HA New Business Enrollment or Change Form Upstate
- LIA HA Broker Registration Form
- LIA HA Electronic Debiting Form
- LIA HA Required Documentation Ancillary
- LIA HA Required Documentation Medical