Pedagogues NOT on the QBank and other non-administrative employees must submit an Employee and Retiree Health Benefits Application (ERB) in order to enroll in or alter your health benefits. You can also obtain this application from your school secretary or HR representative.
Samples of titles within these populations include:
- Education Paraprofessionals
- Family Paraprofessionals (Family Worker, Parent Program Assistant)
- Hourly School Support Staff (School Aide, Health Service Aide, School Lunch Helper)
- School safety staff (School Guard, School Safety Officer)
- Z-status Per Diem (Long term day-to-day sub)
- F-status Per Diem (State certified employee working at least two and a half days a week on a pre-fixed schedule)
- Per Session Staff (Employees working pre or post school hours, summer school or any period of time during which the schools are officially closed)
- Custodial Engineers
Once you have completed the form and your payroll secretary or HR representative has completed and signed Section J, you must submit the completed form via fax, mail, or in person.
(Attn: HR Connect Health Benefits Administration Office)
HR Connect Health Benefits Administration Office
65 Court Street, Room 101
Brooklyn, NY 11201
At the HR Connect Walk-in Center at 65 Court Street, Room 102.
Please make sure you attach copies of all appropriate supporting documents required for eligible dependents, (e.g., marriage, domestic partnership, birth or adoption and/or student certificates). Copies need not be certified.
New hires and those adding or dropping a dependent due to a life event: Please note that you must submit your application for health insurance within 31 days of your start date. Once submitted, benefits typically take 4-6 weeks to be processed.