ABOUT THE PLAN
Features & Benefits
Facts About the Plan
Schedule of Benefits
Want to Participate?
FOR EMPLOYERS
Eligibility
Employer FAQ's
Administration Manual
Electronic Billing & Pmts.
Update Unit Info
Enrollment
Filing a Claim
Forms
Non-Participating Groups
Open Enrollment
FOR MEMBERS
Eligibility
Member FAQ's
Schedule of Benefits
What if I'm disabled?
Enrollment
Filing a Claim
Forms
HOME
UPDATE UNIT INFORMATION
Update group information direct and eliminate phone calls.
Download a printable version
of the form, or complete and submit the form below:
PERSI Unit #:
Name of Employer
Enrollment Contact:
Billing Contact:
Mailing Address 1:
Mailing Address 2:
City:
State:
ZIP:
Phone:
Fax:
Email:
# of Eligible Employees:
