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The Prudential Insurance Company of America fax number
(877) 605-6671
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Group Medical Underwriting
Used for: Submission of Evidence of Insurability (EOI) forms for group medical coverage; fax completed forms to 877-605-6671 or mail to the Group Medical Underwriting department.
Fax destination details
- Department
- Group Medical Underwriting
- Purpose
- Submission of Evidence of Insurability (EOI) forms for group medical coverage; fax completed forms to 877-605-6671 or mail to the Group Medical Underwriting department.
- Form
- Short Form Health Statement — Short Form Health Statement (Evidence of Insurability)
- Address
- The Prudential Insurance Company of America, Group Medical Underwriting, P.O. Box 8796, Philadelphia, PA 19176
- Voice phone
- 888-695-6947; 855-253-9101; 888-257-0412
- Website
- Visit organization website
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- Confirm that this exact department handles your document or request.
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Fill out the form in blue or black ink, sign and date it, and include any required medical information. Mail to The Prudential Insurance Company of America, Group Medical Underwriting, P.O. Box 8796, Philadelphia, PA 19176, or fax the completed form to 877-605-6671.
Official form instructions are published as a downloadable file on the organization's website.
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