Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with 1199SEIU National Benefit Fund before sending sensitive documents. FaxFlow is not affiliated with this organization.
1199SEIU National Benefit Fund fax number
(646) 473-7089
Retiree Health Benefits – Medicare Part B Premium Reimbursement
Used for: Filing Medicare Part B premium reimbursement claims using the Medicare Part B Reimbursement Claim form; submit claims for eligible years (last two years) by mail or fax; include supporting documents such as SSA award letter and proof of Medicare Part B premium payment.
Fax destination details
- Department
- Retiree Health Benefits – Medicare Part B Premium Reimbursement
- Purpose
- Filing Medicare Part B premium reimbursement claims using the Medicare Part B Reimbursement Claim form; submit claims for eligible years (last two years) by mail or fax; include supporting documents such as SSA award letter and proof of Medicare Part B premium payment.
- Form
- Medicare Part B Reimbursement Claim — Statement of Claim for Medicare Part B Premium Reimbursement
- Address
- PO Box 2661, New York, NY 10108-2661
- Voice phone
- (646) 473-8666
- 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.
Complete the form with member and spouse details, select claim year and months, attach required documents (SSA award letter, Medicare card, proof of premium payment), sign and date, then submit by mail, fax, or email as directed.
Official form instructions are published as a downloadable file on the organization's website.
Sources and verification
FaxFlow records the public sources found during directory research. A source link is useful evidence, but it is not a guarantee that a number still reaches the same team.
No public source link was saved with this record. Confirm the number directly with the organization before using it.