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DC 37 Health & Security Plan fax number

(212) 298-9880

Eligibility Enrollment Unit

Used for: Enrollment and status-change processing for the DC37 Health & Security Plan; submission of Enrollment Form and Change of Status Form via fax.

Fax destination details

Department
Eligibility Enrollment Unit
Purpose
Enrollment and status-change processing for the DC37 Health & Security Plan; submission of Enrollment Form and Change of Status Form via fax.
Form
Enrollment Form; Change of Status Form — DC37 Health & Security Plan Enrollment Form; Change of Status Form
Address
DC37 Health & Security Plan, 125 Barclay Street, Room 811, New York, NY 10007-2179
Voice phone
(212) 815-1234

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Complete the Enrollment Form (attach required documents where applicable) and submit to the Eligibility Enrollment Unit; for changes, use the Change of Status Form; fax to 212-298-9880 or mail to 125 Barclay Street, Room 811, New York, NY 10007-2179.

Official form instructions are published as a downloadable file on the organization's website.

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