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State Employees’ Insurance Board (SEIB) – Alabama fax number

(334) 859-6581

Enrollment/Benefits Enrollments

Used for: Enrollment form submission for state employee health and related benefits (e.g., enrollment changes, new enrollments, and beneficiary/admin forms)

Fax destination details

Department
Enrollment/Benefits Enrollments
Purpose
Enrollment form submission for state employee health and related benefits (e.g., enrollment changes, new enrollments, and beneficiary/admin forms)
Form
IB02DS; IB03; IB04KH — Active Employee Enrollment (IB02DS), Status Change (IB03), and Retirement/Other Enrollment Forms (IB04KH) for SEIB
Address
201 South Union Street, Suite 200, Montgomery, Alabama 36130-4900
Voice phone
(334) 859-6640

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.

Submit enrollment and status-change forms to SEIBEnrollments@alseib.org; refer to form PDFs for detailed instructions. See official SEIB site for forms.

Review official form instructions

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