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- SF2809 - Health Benefits Election Form
Authority: OPM is authorized to collect the information requested on this form pursuant to Title 5, U S C Chapter 89 and Title 5 of the Code of Federal Regulations, Part 890 pertaining to enrollment in the Federal Employees Health Benefits (FEHB) Program
- Health Benefits Election Form
Federal Employees Health Benefits Program (FEHB Program) which includes FEHB and Postal Service Health Benefits (PSHB) plans Read the instructions carefully to understand your election and to find the codes referenced in this form
- Form Approved: Employee Health Benefits Election Form
To enroll in a Health Maintenance Organization (HMO), you must live (or in some cases work) in a geographic area specified by the carrier To enroll in an employee organization plan, you must be or become a member of the plan’s sponsoring organization, as specified by the carrier
- Eligibility for Health Benefits - U. S. Office of Personnel Management
Health benefits actions are taken on either the Health Benefits Election Form (SF 2809) or the Notice of Change in Health Benefits Enrollment (SF 2810) Each of these forms contains instructions explaining its use
- Notice of Change in Health Benefits Enrollment
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
- Eligibility Enrollment - U. S. Office of Personnel Management
Health Benefits Election Form (SF 2809) (PDF file) If an employee dies, he she will not have an FEHB Self Plus One or Self and Family enrollment for his her survivors to continue, even if he she is eligible for a survivor annuity
- Forms and Brochures - U. S. Office of Personnel Management
The General Services Administration (GSA) allows the use of PC-based, agency-generated substitute forms, and OPM will accept substitute health benefits forms that meet GSA and OPM requirements
- Health Benefits Election FormStandard Form (SF) 2809 GuidanceFor Tribal . . .
This guidance explains how to complete the Health Benefits Election Form (SF 2809) as a tribal employee The SF 2809 was written for all Federal employees and not all parts of the SF 2809 apply to tribal employees
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