On this page you will find links to the forms Gundersen Lutheran Health Plan employers need most often. If you have questions, please contact us and ask to speak to a representative from the Group Administration Department.

• Wisconsin Waiver of Coverage
• Wisconsin Initial Enrollment and Change
• Iowa Waiver of Coverage
• Iowa Initial Enrollment and Change

Please mail completed forms to:

Gundersen Lutheran Health Plan
1836 South Avenue, Mail Stop: NCA2-01
La Crosse, WI 54601 or fax completed forms to 608-775-8060.