To Request Billing Changes This Form Must Be Returned To MMBB
1. Only an authorized Church/Employer representative (an individual authorized to report changes on behalf of the church) should report
all compensation changes for employees who are participating in the Comprehensive Plan, Retirement Only, or the Member Contribution
Plan using one of the following:
a. Mail this form to MMBB Financial Services at 475 Riverside Drive, Suite 1700 New York, NY 10115.
b. Email this form to forms@mmbb.org.
c. Fax this form to the attention of Billing at 800.986.6782.
d. Any questions, please call a Senior Benefit Specialist at 800.986.6222.
Please do not send billing changes to the lockbox address in Dallas.
2. If there are any changes in the amount of contributions for the Member Contribution Plan, a new Salary Reduction Agreement form (A-13a)
must be completed.
3. If there are any changes to contributions for the Retirement Only Plan, a Change of Contribution form (A-13b) must be completed.
New Enrollment in the Retirement Only Plan or the Member Contribution Plan
When a member enrolls in either of these plans for the first time, a Membership Application form (A-1) must be completed. In addition when
enrolling in the Member Contribution Plan, a Salary Reduction Agreement form (A-13a) is also required.
Special Note for Clergy
Clergy who wish to enroll in the Member Contribution Plan must have reported cash compensation. In addition there is an IRS limit to the
amount of employer contributions available to clergy reporting 100% of compensation as housing allowance. Please contact a Senior Benefits
Specialist for details.
To request any of the forms noted above, email us at service@mmbb.org or call us toll free.
Billing Reminders