1199SEIU Benefit Funds fax number

Fax destination details

Department

Pension Fund Administration

Purpose

Submit ESRD Medical Evidence Report to the Benefit Funds; pension applications (Normal/Early/Disability) also documented via mail or fax to the relevant 1199SEIU pension fund.

Form

ESRD Medical Evidence Report — ESRD Medical Evidence Report

Address

PO Box 975, New York, NY 10108-0975

Voice phone

646-473-8666; 800-575-7771

Website

Visit organization website

Before you send

• Confirm that this exact department handles your document or request.
• Check the organization website or call its main line for the current fax number.
• Include a cover sheet and any case, member, claim, or form reference required.
• Keep the delivery confirmation with your submission records.

If you have End-Stage Renal Disease (ESRD), provide the ESRD Medical Evidence Report to the Benefit Funds’ Eligibility Department. Fax it to 646-473-6829 or mail to 1199SEIU Benefit Funds, PO Box 1144, New York, NY 10108-1144. For pension applications (Normal/Early/Disability), follow the form instructions (GNYFP1/NPFP1) and fax/mail to the appropriate Pension Fund.

Official form instructions are published as a downloadable file on the organization's website.