Online Enrollment

Online Enrollment Policy
(Adopted via Resolution No. 003-2018)

Required Documents:  Municipal Determination of Subscriber Online Enrollment Commitment

Instructions for Enrollment Additions/Deletions/Changes:
Submit customized form link below and Dependent Eligibility Verification Form if applicable:

  • By secure Web Portal (Benefit Clerks should contact Kylie Rodrigues, Benefits Specialist, at the Consortium for log-in instructions); or
  • by fax: 607-273-5854; or
  • by US Mail (an additional time lag built into this process) to:
      Greater Tompkins County Municipal Health Insurance Consortium
      Attn: ­­­­­­­­­­­­­­­­­Enrollment, P.O. Box 7, Ithaca, New York 14851

Once the enrollment application is received by the Consortium, the enrollment data will be submitted online within three (3) business days.  Confirmation of enrollment will be confirmed by the Consortium within 3 days of entering the change in the Excellus enrollment software. Should Excellus software not accept the enrollment submission, notice of incomplete information will be sent to the municipal partner within three (3) business days. 

Enrollment delegated to Consortium: 
(Forms linked to municipality)
Municipalities responsible for enrollment: 
Town of Aurelius Seneca County
Town of Caroline Tompkins County
Town of Catharine City of Cortland
Town of Cincinnatus City of Ithaca
Town of Cuyler Town of Big Flats
Town of Danby Town of Dryden
Town of Dix Town of Groton
Town of Enfield Town of Ithaca
Town of Hector Town of Lansing
Town of Homer Town of Ulysses
Town of Horseheads Village of Cayuga Heights
Town of Marathon Village of Groton
Town of Mentz Village of Owego
Town of Montezuma Village of Trumansburg
Town of Moravia  
Town of Newfield   
Town of Niles  
Town of Owasco  
Town of Preble  
Town of Scipio   
Town of Sennett  
Town of Springport   
Town of Spencer    
Town of Tioga   
Town of Truxton  
Town of Virgil  
Town of Willet  
Village of Dryden  
Village of Freeville  
Village of Homer  
Village of Horseheads  
Village of Lansing  
Village of Union Springs   
Village of Watkins Glen  
Lansing Community Library