This form will take 05-10 minutes to complete.
Active Employee
For City employees with access to the City’s network, you will be authenticated and see your personalized benefits portal. For City employees who are not signed into the City’s network, you will need to sign in with your network account. You can find step by step instructions on how to complete your submission here: Benefits Portal Login Instructions
For City employees without a City email or limited access to the City’s network, you will need to create your own account by following the Retiree/COBRA benefits portal. Both active employees and retiree/COBRA participants use the same system. You can find step by step instructions on how to complete your submission here: Benefits Portal Login Instructions (No City Email or Limited Access)
Retiree/COBRA Employee
When signing in or creating an account users are taken to the portal's welcome page. To set up an account select the "register" button on the right side.
The registration page will open up giving you instructions to enter your SSN and date of birth, then click to continue. The system should allow you to create an account with a login username and password. Once signed in, you’ll see your personalized benefits portal. Click on the blue button “start” or “review” to enroll in your benefits.
You can find step by step instructions on how to complete your submission here: Benefits Portal Login Instructions (No City Email or Limited Access)