A membership application form

Membership in the fund is a voluntery for employees. Applicants must fill and send the application within two months of the commencement of employment. All membership issues including new members are addressed in the meeting of the board. Applicants will be notified of the start of membership.

The applicant gives his/her consent to the forwarding of the joining information to the employer.

The applicant authorises the employer to collect the membership fee from his/her salary and pay it to the health insurance fund.

Surname

Firstname

Personal identity code

Address

Postal code and City

Phone number

E-mail

IBAN account number

Employer

Employment start date

End date of fixed-term employment

More info

Updating personal information is the member's own responsibility.

Familiarising oneself with the fund's rules is the member's own task.

The rules will be sent to the member's email address at the start of the membership.

Changes to the rules will be announced on the website of the health insurance fund.