2020 Open Enrollment/Transfer Period Information and Forms

2020 Open Enrollment Virtual Fair Videos

Please find below videos of CCNY Human Resources’ Open Enrollment Virtual Fairs previously held on 10/14/20 and 10/21/20.

Feel free to view the presentations if you did not have the time to join us. You will find the presentations to be very informative.

10/14/21 - Open Enrollment Virtual Fair Video Recording

10/21/20 - Open Enrollment Virtual Fair Video Recording

BENEFIT PLAN
OPEN ENROLLMENT/
TRANSFER PERIOD
Catastrophic Sick Leave Bank Program

Catastrophic Sick Leave Bank Program Information

Catastrophic Sick Leave Bank Program - Application to Donate Sick Leave

Catastrophic Sick Leave Bank Program - Application to Receive Sick Leave

Catastrophic Sick Leave Bank Program - Application to Change or Withdraw

     October 15th - November 15th 
Flexible Spending Accounts Program - FSA

Plan Year 2021 - Flexible Spending Accounts Program Brochure

Plan Year 2021 - Flexible Spending Accounts Program Application

Plan Year 2021 - Frequently Asked Questions

Note: Current FSA 2020 participants (HCFSA & DeCAP) will receive 2021 re-enrollment packets automatically to the address on file.

The Flexible Spending Accounts Program client service center is closed. Due to the closure of the office, if you mailed or faxed forms or correspondence March 11, 2020 or after, we cannot access or process that form.

IMPORTANT: Please read about Program changes due to COVID-19

Please resubmit your forms and documents as follows:

1) Inquiries and questions can be sent via email to the Program.

2) Forms/documents can be sent via secure email to: https://asonet.com/emailFSA.aspx

Please do not submit your form/document more than once.  This will only delay processing.

3) Forms can also be faxed to: (877) 290-6587

Also, please do not send forms or documents via express mail.  The office is closed and the package cannot be accepted.

Please check back periodically for updates and how to send forms and claims electronically to the Program.

      October 1st - November 13th 
Flexible Spending Accounts Program - Buy-Out Waiver

Health Benefits Buy-Out Waiver Program Information

Plan Year 2021 - Buy-Out Waiver Program Application

Health Insurance Application

      October 1st - November 13th
NYC Health Benefits Program

2019 Fall Transfer Period Information 

Health Insurance Application

Health Benefits Program - Dependent Eligibility Required Documentation

Health Plans Summary of Benefits and Coverage (SBC)

NYC Health Benefits Program Summary Plan Description (SPD)

July 2020 Basic Plan and Optional Rider Rate Sheet

        October 1st - October 30th  
PSC-CUNY Welfare Fund

PSC-CUNY Welfare Fund Dental 

        October 1st - October 30th