Employee Benefit Fund Enrollment Form

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Not Yet Enrolled?

If you are not enrolled in our benefits, please enter your social security number below to begin the simple enrollment process.

Please Note:

  • CSEA Union Membership does not guarantee eligibility for EBF Benefits.
  • This form is to be completed by the member, NOT the employer. Employer must notify CSEA EBF of eligibility separately.
Step 1.
Please enter your social security number so we can check your current enrollment status →
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You have entered an invalid SSN. Please re-enter your 9 digit SSN

You have entered an invalid NYS Employee ID. Please check the number and re-enter it.