Standard Form 2809. Web fehb sf 2809 health benefits application form. Chapter 89, title 5, u.s.
OPM Form 2809 Edit, Fill, Sign Online Handypdf
•annuitants retired under the civil service retirement system (csrs) or federal employees retirement system (fers) •survivor annuitants under csrs or fers. •children and former spouses who are eligible for temporary continuation of coverage. Or elect not to enroll in the fehb program (employees only); Web data standards request form: Or change your fehb enrollment from self only to self and family and/or from your present plan or option to another plan or option because of an event described in the table beginning on page 6; Or cancel your fehb enrollment; Or • suspend your fehb enrollment (annuitants or former spouses only). Web fehb sf 2809 health benefits application form. Report of withholdings and contributions for health benefits by enrollment code Web uses for standard form (sf) 2809 use this form to:
Web fehb sf 2809 health benefits application form. Health benefits registration form (only for use by annuitants and former spouses of annuitants) opm 2810: Pdf versions of forms use adobe reader ™. Enroll in the fehb program; •annuitants retired under the civil service retirement system (csrs) or federal employees retirement system (fers) •survivor annuitants under csrs or fers. Web uses for standard form (sf) 2809 use this form to: •children and former spouses who are eligible for temporary continuation of coverage. • enroll or reenroll in the fehb program; Or • suspend your fehb enrollment (annuitants or former spouses only). Or change your fehb enrollment from self only to self and family and/or from your present plan or option to another plan or option because of an event described in the table beginning on page 6; Notice of change in health.
