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West Campus, Health Sciences, and School of Medicine



If you are eligible for health insurance and would like to enroll please make sure you bring copies of the following documents for yourself, spouse and any dependents you would like to enroll, to the orientation. No substitutions will be allowed and the Department of Civil Service will not accept any enrollment applications without the required documents.


Required Proofs

Individual Spouse Domestic Partner Child(ren) M/C, PBANYS, PEF, NYSCOPA and GSEU dependents age 19 to 25 — Dental & Vision Coverage only
Birth Certificate or Passport Birth Certificate or Passport Birth Certificate or Passport Birth Certificate Proof of full-time student status: Vision Student Verification Form
Social Security Card Marriage Certificate Social Security Card Proof of support/ dependence of other children (if applicable) Proof of full-time student status: Dental Student Verification Form
  Joint Ownership Document, if married for over 1 year Two forms of acceptable proof to prove joint responsibility for basic financial obligations. Proof of disability (if applicable)  
  Affidavit of Marriage Certificate
(If you can't provide joint financial document as described here)
One form of acceptable proof to prove that you and your Domestic Partner reside together.    

*All documents must be translated into English. 



As applicable, please also include copies of the following

  • Married more than one year? Also provide proof of currentjoint ownership
  • Proof of full-time student status for dependents age 19 to 25 (Dental & Vision Coverage only — M/C, PBANYS, PEF, NYSCOPBA and GSEU)
  • Proof of support/dependence
  • Proof of disability
  • Medicare card

Examples of Joint Ownership 

Documents must have enrollee’s name and spouse’s name on the statement.

→Prior year tax return
→Mortgage statement
→Bank account statement
→Homeowners/renters insurance policy
→Renter/lease agreement
→Credit Card statement
→Utility statement

If you cannot provide the joint financial documents as described above, you may submit an Affidavit of Marriage Certificate.


*You have to pay for the translation

Service Address Phone Number
Istra Business Service 759 Durham Road
Sayville, NY 11782
Multinational Translating Service 36 Carleton Ave
Islip Terrace, NY 11752
All-Round Typing & Translations
German, French, Italian, Spanish
Gisela Zabriskie
MMR Enterprises  20 Earl Avenue
Northport, NY 11768
Romanian & French Language
239 N Hawthorne Street
Massapequa, NY 11758
Accredited Language Services 18 John Street
Suite 300
New York, NY 10038


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