Email Us

Our representatives will respond within one business day. If you need an immediate response, please call us at the number on your member card.

If you have coverage through an employer group, the majority of demographic changes (e.g., name, date of birth, Social Security number, and address) must be completed through your group.

If you enrolled through the NY State of Health Marketplace, please visit their website to update your policy.

How Can We Help You?

For Web site problems, contact our Web Security Help Desk

Step 1: Select a Claim Form:

Step 2: Fill Out the Form & Save it to Your Computer

Step 3: Send to Us Electronically

At this time, electronic methods are preferred over mail.

  1. Please utilize the appropriate form. Refer to the Print FormsPrint Forms page for a downloadable PDF.
  2. Fill out the form, sign it if necessary, then scan the form and save the file (e.g. .pdf, .docx, .jpg) to your computer
  3. Electronically submit your correspondenceElectronically submit your correspondence (Login Required), such as:
    • Grievance/Appeal
    • HIPAA Authorization
    • Medical Records
    • Membership/Enrollment Application or Documentation
    • Other Letter/Correspondence
  • Please limit submissions to common file types: PDF, Word, TIFF, JPG, PNG.
  • Please allow up to 72 hours for a reply. Note: The 72-hour time-frame does not include the time required to process your document.

If you are unable to submit your documentation electronically, you may continue to submit your documentation via mail to the address on the back of your member card. Please note, there may be significant delays with the processing of documents received by mail at this time.

For Name, Social Security Number, or Date of Birth Changes, contact Membership & Billing.

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