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General Information

New Group Installation

Employee Census Information Template
Employer EFT/ACH Form
Enrollment/Change Form - All Plans Portfolio
Enrollment/Change Form - Long Island Easy Par
Enrollment/Change Form - Mid-Hudson Portfolio
Group Application Notice of Election

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Broker Direct Deposit
Broker of Record Change Form
Business Associate Agreement
Credentialed Agent Agreement
Selling Agent Application
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Webinars

10/14/2025 - Fall Broker Webinar Slide Deck
10/14/2025 - Fall Broker Webinar Video
11/12/2025 - Adding it Up in 2026 Slide Deck
11/12/2025 - Adding it Up in 2026 Video

Broker Marketing

Benefits Exchange One Pager
Benefits Exchange Proposal

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HealthPass
112 W 34th Street, 18th Floor
New York, NY 10120
1-888-313-7277

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