Standard Form 2809

Standard Form 2809 - •annuitants retired under the civil service retirement system (csrs) or federal employees retirement system (fers) •survivor annuitants under csrs or fers. Or elect not to enroll in the fehb program (employees only); Health benefits registration form (only for use by annuitants and former spouses of annuitants) opm 2810: Previous edition is not usable. Web fehb sf 2809 health benefits application form. Report of withholdings and contributions for health benefits, life insurance, and retirement: Web health benefits election form. Pdf versions of forms use adobe reader ™. Notice of change in health benefits enrollment: Or suspend your fehb enrollment (annuitants or former spouses only).

For agency distribution of copies, see page 5. Web health benefits election form. Employee health benefits registration form: Health benefits registration form (only for use by annuitants and former spouses of annuitants) opm 2810: •annuitants retired under the civil service retirement system (csrs) or federal employees retirement system (fers) •survivor annuitants under csrs or fers. Or • cancel your fehb enrollment; Web uses for standard form (sf) 2809 use this form to: Web health benefits election form form approved: Web data standards request form: •children and former spouses who are eligible for temporary continuation of coverage.

• enroll or reenroll in the fehb program; Web data standards request form: Notice of change in health benefits enrollment: Web health benefits election form form approved: Instructions for completing opm 2809. For agency distribution of copies, see page 5. Previous edition is not usable. Health benefits registration form (only for use by annuitants and former spouses of annuitants) opm 2810: •annuitants retired under the civil service retirement system (csrs) or federal employees retirement system (fers) •survivor annuitants under csrs or fers. Web who may use opm form 2809.

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Instructions For Completing Opm 2809.

Report of withholdings and contributions for health benefits, life insurance, and retirement: Health benefits registration form (only for use by annuitants and former spouses of annuitants) opm 2810: Web who may use opm form 2809. Employee health benefits registration form:

• Enroll Or Reenroll In The Fehb Program;

Web health benefits election form. Or suspend your fehb enrollment (annuitants or former spouses only). Enroll in the fehb program; Chapter 89, title 5, u.s.

Web Health Benefits Election Form Uses For Standard Form (Sf) 2809 Use This Form To:

Previous edition is not usable. Or • elect not to enroll in the fehb program (employees only);or • change your fehb enrollment; Notice of change in health benefits enrollment: • switch designated eligible family member;

By Human Capital November 1, 2019.

Web fehb sf 2809 health benefits application form. For agency distribution of copies, see page 5. Or • cancel your fehb enrollment; Web uses for standard form (sf) 2809 use this form to:

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