mybenefits logo STATE OF NEW MEXICO — GROUP BENEFITS PLAN

FMLA & LWOP Premiums Dues

• FMLA & LWOP Self-Pay Transmittal Form (State)
• FMLA & LWOP Self-Pay Transmital Form (LPB)
• Premium Due-FMLA initial Notice
• Premium Due-FMLA Second Notice
• Premiums Due-FMLA Final Notice
• Premiums Due-LWOP Initial Notice
• Premiums Due-LWOP Second Notice
• Premiums Due-LWOP Final Notice

CONTACT

Location

Erisa Administrative Services, Inc. Office
1200 San Pedro Drive NE
Albuquerque, NM 87110

Phone

Albuquerque: (505) 244-6000
Toll Free: (855) 618-1800
Fax: (505) 244-6009

Email

SONM@easitpa.com

FSA@easitpa.com

Business Hours

Monday - Friday: 8:00 AM - 5:00 PM
Saturday - Sunday: Closed
Erisa is closed for New Year
President’s Day, Memorial Day
Independence Day, Labor Day
Thanksgiving (two days) and
Christmas (two days)