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  • SF2809 - Health Benefits Election Form
    Who May Use SF 2809 Employees eligible to enroll in or currently enrolled in the FEHB Program Employees automatically participate in premium conversion unless they waive it, see page 6
  • Health Benefits Election Form
    Who May Use OPM Form 2809 Annuitants retired under the Civil Service Retirement System (CSRS) or Federal Employees' Retirement System (FERS), electing or changing either their FEHB or Postal Service Health Benefit (PSHB) coverage under the FEHB Program;
  • Standard Forms - U. S. Office of Personnel Management
    Welcome to opm gov Standard Forms are used governmentwide for various employment and benefits program purposes Browse the listing below to download your choice of form (s) On June 26, 2013, the Supreme Court ruled that Section 3 of the Defense of Marriage Act (DOMA) is unconstitutional As a result of the Supreme Court’s decision, the United States Office of Personnel Management (OPM) will
  • Healthcare - U. S. Office of Personnel Management
    The FEHB plan brochuresshow you what services and supplies are covered and the level of coverage Review the brochures carefully The brochures are formatted to ensure they are all organized alike You can get brochures from the health plans or your human resource office When it comes to your health care, the best surprise is no surprise
  • Form Approved: Employee Health Benefits Election Form
    At Part D of the SF 2809, Health Benefits Election Form, you must designate your two-character event code (for example, 1A) and the date of the event using numbers to show month, day, and complete year; e g , 06 30 1998
  • OPM Forms
    Welcome to opm gov Browse and download your choice of form (s) issued by the Office of Personnel Management
  • Notice of Change in Health Benefits Enrollment
    Purpose of Form efits Registration Form (Standard Form 2809) When an action requires a change in health benefits enrollment, prepare SF 2810 As Soon As the Effective Date Is Known and give the appropriate copies the enrollee and payroll office Immediately Preparation and distribution of copies should not be delayed pending SF 50 action in t
  • Forms and Brochures - U. S. Office of Personnel Management
    Forms and Brochures Each employing office must keep a supply of the following FEHB forms on hand to meet anticipated needs: Forms for employee use: Health Benefits Election Form (SF 2809) Notice of Change in Health Benefits Enrollment (SF 2810) Temporary Continuation of Coverage (TCC) under the Federal Employees Health Benefits Program (RI 79-27) Forms for employing office use: Report of
  • Retirement Insurance Forms
    Welcome to opm gov Browse and download your choice of form (s) used to process retirement and insurance benefits Get Retirement pamphlets here
  • Enroll - U. S. Office of Personnel Management
    Compensationers: Compensationers may review and or download the SF 2809 They may send a written request for an Open Season enrollment change to the Office of Workers' Compensation Programs at this address: FECA Central Mailroom P O Box 8311 London, KY 40742 They should include their compensation claim number on all requests They should be aware of the following information: The effective





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