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Get LTCG CLM-001 Online Claim Form

claim form, a copy of your Government Issued Photo Identification (ID) such as your driver’s license, state issued ID card or passport and all available claim documentation to: CalPERS Long-Term Care Program P.O. Box 64902 St. Paul, MN 55164-0902 FAX: (866) 294-6967 We will contact you or your designated representative within five to ten business days of receipt of your documents to advise that we have received your request for benefits and inform you if additional information is needed. C.

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