Form 1054: Fill out & sign online

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to rapidly redact Www1 nyc assetsolrHealth Benefits Program Health Benefits Report Inquiry online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Dochub is the greatest editor for modifying your documents online. Follow this simple guide to redact Www1 nyc assetsolrHealth Benefits Program Health Benefits Report Inquiry in PDF format online at no cost:

Register and sign in. Create a free account, set a secure password, and proceed with email verification to start working on your forms.
Upload a document. Click on New Document and choose the file importing option: add Www1 nyc assetsolrHealth Benefits Program Health Benefits Report Inquiry from your device, the cloud, or a secure URL.
Make changes to the template. Take advantage of the upper and left-side panel tools to edit Www1 nyc assetsolrHealth Benefits Program Health Benefits Report Inquiry. Add and customize text, pictures, and fillable areas, whiteout unneeded details, highlight the important ones, and comment on your updates.
Get your documentation completed. Send the form to other individuals via email, generate a link for quicker document sharing, export the template to the cloud, or save it on your device in the current version or with Audit Trail added.

Discover all the advantages of our editor right now!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Contact us

What is the number for NYC DOE HR?

Changes In Family Status - Adding/Dropping Dependents Employees should report all changes in family status to their agency health benefits or payroll office or NYCAPS Central at (212) 487-0500 (Department of Education employees should contact HR Connect at (718) 935-4000) within 30 days after the event.

How do I contact OLR NYC?

As always, you can speak with a Customer Service Representative about the Plan and your account(s) on the phone by calling at (212) 306-7760.

How do I email NYC health benefits?

Speak to a benefits specialist We are available to answer your questions by phone or email Monday - Friday, 8 a.m. to 6 p.m. Call 646-458-5634 or email HHCBenefits@nychhc.org and we will connect you to the appropriate staff member.

How do I check if my health insurance is active in NYC?

How to tell if your health insurance is active Log in to your HealthCare.gov account. Select your completed application under Your Existing Applications. Click on My Plans Programs to see which plan(s) youre enrolled in.

How do I contact NYC DOE health benefits?

Contact your agency health benefits or payroll office or NYCAPS Central at (212) 487-0500. Department of Education employees should contact HR Connect at (718) 935-4000: For questions concerning eligibility and enrollment. For questions regarding deductions for health benefits.

Related forms

be ready to get more