Enrolling Individual Employees
If you provide Long-Term Disability Insurance as a benefit of employment, current employees are enrolled as of the date you adopted the plan.
You must enroll all eligible new employees within 31 days of their hire date. If you enroll employees after 31 days, your organization will be responsible for back premiums.
When a new employee decides to purchase Long-Term Disability individually, be sure to enroll him or her within 31 days of their date of hire. After 31 days, an Evidence of Insurability (EOI) form* is required, and acceptance is not guaranteed.
How To Enroll Employees
Submit the Employee Enrollment Form for Group Life, LTD, & STD (formerly Enrollment Data Collection Form) to:
- Your Diocesan Administrator, if you enroll employees in medical and other benefits through your diocese, or
- Directly to:
19 East 34th Street
New York, NY 10016
For more information:
- Call Client Services at (855) 215-5990, Monday – Friday, 8:30AM – 8:00PM ET (excluding holidays), or Email us
*Please download this form and open using Adobe Acrobat reader for proper functionality
Policy Number: CNYEX01112
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