32bj dependent enrollment form 2026

1. Click ‘Get Form’ to open the 32bj dependent enrollment form in the editor.
2. Begin with Section 1, where you will enter your participant information. Fill in your first name, middle name, last name, gender, street address, city, state, zip code, and email address.
3. Proceed to Section 2. Here, provide your Social Security Number, date of birth, and telephone numbers for both day and evening. If there has been a change in marital status, check the appropriate box and attach required documents.
4. In Section 3, enroll any dependents by indicating their details such as name, relationship (biological child, adopted child), date of birth, and whether they are enrolled in another healthcare plan.
5. Finally, complete Section 4 by signing the form and entering the current date. Ensure all information is accurate before submitting.

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