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Greater Tompkins County Municipal Health Insurance Consortium

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Municipal Resources

  • Joining:
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  • Benefit Plans and Optional Programs
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Municipal Forms:

  1. Municipal Dependent Verification Certification (to be submitted to the Consortium through its Administrative Portal) 

New Member/ Subscriber Forms (to be kept on file by employer):

  1. Member Eligibility Verification Form
  2. Documentation Required for Verifying Member Eligibility 
  3. Covered Dependent Definitions
  4. Domestic Partner Affidavit Form

GREATER TOMPKINS COUNTY MUNICIPAL
HEALTH INSURANCE CONSORTIUM

Mail:  PO Box 7, Ithaca, NY 14851
Headquarters:  215 N. Tioga St., Ithaca, NY 14850
(607) 274-5590

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