Graduate students employed by New York State and represented by GSEU enroll in health insurance and submit health insurance changes for life events such as modifying dependents.
For the best experience in completing this form use a non-mobile
120 Crofts Hall
Read and complete both sides/pages. Please print and check the
Form Type: Downloadable, PDF document
Requirements: Adobe Reader
Updated: February 2007
Owner: State of New York Department of Civil Service