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Health Benefit Forms

Hempstead Public Schools provides eligible employees with access to a comprehensive benefits package designed to support their health, wellness, and financial security. This page contains required forms related to enrollment, changes, and coverage for medical, dental, vision, and life insurance benefits.

Available Benefit Programs

Health benefit forms may include, but are not limited to, the following plans:

  • New York State Health Insurance Program (NYSHIP)

  • Emblem Health

  • Dental Insurance

  • Vision Insurance

  • Life Insurance

Enrollment and Changes

Employees may submit benefit forms during open enrollment periods or following a qualifying life event, such as marriage, birth, adoption, or loss of coverage. All submissions must comply with plan guidelines and required timelines.

Important Information

Employees are encouraged to review plan materials carefully to understand coverage options, eligibility requirements, contribution amounts, and documentation needs. Timely submission of accurate forms helps ensure uninterrupted coverage.

Questions or Assistance

For questions regarding eligibility, enrollment, or required documentation for health benefits, please contact the Human Resources Department for guidance and support.

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