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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
- 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
- Employee Health Benefits Election Form
The information you provide on this form is needed to docu-ment your enrollment in the Federal Employees Health Benefits Program under Chapter 89, title 5, U S Code
- 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
- BAL 24-103 - Process Change for Open Season Elections Effective After . . .
Retiring employees who want to make an FEHB Open Season election that will be effective after their retirement date will need to complete a paper SF 2809, Health Benefits Election Form
- Office of Personnel Management
The purpose of this letter is to notify Federal agencies and retirement systems that the Office of Personnel Management (OPM) has updated the Health Benefits Election Form, Standard Form (SF) 2809
- Enroll - U. S. Office of Personnel Management
You can submit Standard Form 2809, Employee Health Benefits Election Form (PDF file), to your Human Resources Office (Unless you are in U S Postal Service employee)
- Standard Form (SF) 2809 Guidance For Tribal Employers
This guidance explains how to process the Health Benefits Election Form (SF 2809) as a tribal employer The SF 2809 was written for Federal employees and not all parts of the SF 2809 apply to tribal employers or employees
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