What is this for?
To enroll, change, or terminate employees in Group Term Life and Disability Insurance plans.
Please fax the completed form to: (212) 251-8969
or mail to: The Church Pension Fund, 19 East 34th Street, New York, NY 10016, Attn: Client Services
To enroll in certain Long-Term or Short-Term disability plans more than 31 days after starting your job
Send completed form to firstname.lastname@example.org, fax to (800) 206-4063, or mail to Zurich Medical Underwriting, PO Box 1685, Grand Rapids, MI 49501-1685