1199 Seiu Form – Fill Out and Use This PDF

1199 Seiu Form PDF Details

For members of the 1199SEIU Benefit Funds, submitting the 1199SEIU Change of Address Form whenever contact information changes is a critical administrative task. The 1199SEIU Benefit and Pension Funds office is located at 330 West 42nd Street, New York, NY, and can be reached by phone for members throughout the region.

Who Must File the Form

Any healthcare worker, hospital employee, home care worker, or other union member covered under 1199SEIU Benefit Funds plans in New York, New Jersey, Maryland, Massachusetts, or Florida must submit the 1199SEIU Form after moving or changing their phone number or email address. Delaying this submission can result in missed eligibility notices, delayed benefit statements, and lost correspondence about coverage changes.

Required Information

Before completing the form, gather the following details:

• Full legal name as it appears on membership records
• 1199SEIU member ID number
• Previous mailing address, including city, state, and ZIP code
• New mailing address, including city, state, and ZIP code
• Home and cell telephone numbers
• Current email address

Write in blue or black ink throughout, printing clearly so the Member Eligibility Department can process the update accurately.

How to Submit the 1199SEIU Address Form

Mail the completed and signed 1199SEIU Form to the 1199SEIU Benefit and Pension Funds, Member Eligibility Department, at their New York City office. Members should also file a Change of Address Form #3575 with their local Post Office to ensure mail is forwarded correctly during the transition period. Members who need additional benefit paperwork can access the general address change form or the management benefits fund form on FormsPal.

What Happens After You Submit

After mailing the completed form, allow 7 to 10 business days for the 1199SEIU Benefit Funds to update your records. Log in to your online member account to verify that the new address appears correctly. If benefit fund mail continues to arrive at the old address after two weeks, contact the Member Eligibility Department directly to confirm receipt of your submission.