If you have any health benefits related questions, please contact Joan Zaw and Debbie Poon.

Information and Forms

• NYC Benefits Summary Plan Description
• Health Plan and Optional Rider Costs (Effective October 2022)
  • Rate Change Notice
• Health Benefits Enrollment Application (ERB)
• HIP HMO Opt-Out Request Form
  • HIP HMO Service Area
  • HIP HMO Plan Summary
• Dependent Eligibility Documentation
• Domestic Partner Information for CUNY employees
• Domestic Partner Enrollment Information
  • Under IRS rulings, health insurance coverage for domestic partners are included in gross income for taxation purposes, except where the domestic partner is a dependent pursuant to the IRS. For federal tax purposes, the value of the health insurance coverage will be added to the employee’s taxable wages to properly withhold income and employment taxes.
  • You are encouraged to consult with your tax advisor to determine the tax consequences of your domestic partnership health benefits coverage.
• Health Plan Summaries and Contacts
• Health Plan Summary of Coverage and Benefits (SBC)

Changing your Health Benefits (mid-year)

If you experience a major life change, or qualifying life event, you would be entitled to a special enrollment period where you may only have thirty days (30) after the qualifying event to make changes to your coverage. Examples of qualifying events are a change in:

• legal status: getting married or entering into a domestic partnership, divorce or legally separated
• the number of dependents: birth or adoption
• dependent status: a dependent losing coverage under another plan, such as a spouse/partner losing coverage from their employer
• employment status: job changes or transfers that change the benefits offerings

Changing your Health Benefits during the annual Open Enrollment Period

Open enrollment, or fall transfer period, is the time of year when you can make changes to your current insurance plan, or sign up for a new plan, for any reason. Any changes made during the open enrollment period will be made effective the following January. The NYC Office of Labor Relations will have the most up-to-date information for the next annual open enrollment period. More information on health plans and dates can be found here.