• Why Do I Need
  Long Term Care Benefits?
  • Reasons to Choose Long Term Care Benefits
  • A Financial Dilemma…
  • Regional Costs of Care
  • Testimonial -
    Sean Simonson Story
  • Informative Articles
• What Do Long Term Care Benefits Cover?
  • NPFBA Benefits
  • NPFBA Interactive
    Flip Book
  • Power of 5% Compounded Inflation Protection
    • 150/70/50 Plan
    • 130/70/50 Plan
    • 130/50/50 Plan
  • Cost of Waiting
• Why Choose NPFBA?
  • About NPFBA
  • NPFBA Trustees
• How Much Does It Cost?
  • Monthly Costs
    • 150 Comprehensive Plan
    • 130 Comprehensive Plan
  • Cost Comparison
• Apply Now
• Request More Information
• Change of
  Beneficiary Card
• NPFBA Forms
• Glossary
• Scholarship Opportunities
• Contact Us
• Affiliated Programs

 

 

 

 

California Administration Insurance
Services, Inc., Plan Administrators

CA Insurance Lic. #0544968

 

NPFBA Forms

 

Please print and mail forms to NPFBA at the address below. Emailed forms cannot be accepted at this time.

 

Contact Information Update Form - Please use this form to update your contact information.

 

 

Change of Beneficiary Form -

Any of the following events could trigger a change to your beneficiary. Please do not list minors as beneficiaries.

• New marriage

• Dissolution of marriage

• Death of chosen beneficiary

• Creation of a Living Trust

• Children that have become of age (18)

 

Payment Option Change Form - Please use this form to change any payment information.

 

Updated Health Statement

 

HIPAA

 

 

Please mail completed forms to:

NPFBA

PO Box 31

Martell, CA 95654

 

A Jointly Sponsored
Long Term Care Trust
of CLEA and CAPF

 

 

Board of Trustees

Dave Boffi, Co-Chairman

Daly City POA

Gene Dangel, Co-Chairman

San Ramon Valley Firefighters

Dennis Campanale, CFO

West Sacramento Firefighters

Joe Chirillo, CFO

Beverly Hills POA

Mario Yagoda, Secretary

Glendale POA

Bob Perez, Secretary

Santa Barbara Co. Firefighters

Ken Blanton

Kern County Firefighters

Jim Galvin

Los Angeles City Firefighters

Jerry Hall

DSA of Santa Clara Co.

Ken Marlin

San Leandro POA

Erick Mattson

Redding Firefighters

Darin Ryburn

Burbank POA