Enrollment

Public Hospital Enrollment

Materials

To obtain the necessary materiels, please contact the Benefits Office at 212-356-8180. In order to enroll you and any eligible dependents in the Voluntary Hospitals House Staff Benefits Plan, You must complete the following:

Guardian enrollment form

All sections of the CIR Enrollment Card

Emergency Enrollment

In situations where immediate enrollment is necessary, you may download a temporary enrollment card here and fax or mail it to the Benefits Office. It is the policy of the House Staff Benefits Plan that you must also complete an official Enrollment Card.

Health and Hospitals Corporation (HHC) Temporary Enrollment Card

Westchester Medical Center (WMC) Temporary Enrollment Card

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