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ERS, Employees Retirement System of Texas
GBP Supplemental Information
Supplemental Information Form - Active Employees (220K pdf)
Supplemental Information Form - Retirees (271K pdf)

Texas Employees Group Benefits Program (GBP) Supplemental Information Forms for Active Employees and Retirees

IMPORTANT: These forms are for providing other insurance information and selecting a primary care physician (PCP). They are NOT enrollment forms and do NOT verify eligibility.

PLEASE READ INSTRUCTIONS ON BACK BEFORE COMPLETING THESE FORMS.

 
 

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Community First Health Plans is an affiliate of the University Health System.