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- SF2809 - Health Benefits Election Form
Instructions for Completing SF 2809 Type or Print We have not provided instructions for those items that have an explanation on the form
- 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
- 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;
- Forms and Brochures - U. S. Office of Personnel Management
Health Benefits Election form (SF 2809 (PDF file)); no special requirements Notice of Change in Health Benefits Enrollment (SF 2810 (PDF file)); the instructions to Copy 1 (the Enrollee copy) must be on the reverse of Copy 1 or attached to it
- Standard Forms - U. S. Office of Personnel Management
Welcome to opm govStandard 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
- 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
- BAL 24-103 - Process Change for Open Season Elections Effective After . . .
If a retiring employee submits an FEHB Open Season SF 2809 prior to the beginning of the Open Season enrollment period (e g , October retirement), then the agency will need to delay submission of the SF 2809 to the Carrier until after Open Season begins
- Enroll - U. S. Office of Personnel Management
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:
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