Search results with tag "Health benefits election form"
SF2809 - Health Benefits Election Form - OPM.gov
www.opm.govEmployees automatically participate in premium conversion unless they waive it, see page 6. 2. Annuitants in retirement systems other than the Civil Service Retirement System (CSRS) or Federal Employees Retirement System (FERS), including individuals receiving monthly compensation from the Office of Workers’ Compensation Programs (OWCP). Note:
Health Benefits Election Form - OPM.gov
www.opm.govHealth Benefits Election Form Form Approved: OMB No. 3206-0141 Who May Use OPM Form 2809 • Annuitants retired under the Civil Service Retirement System (CSRS) or Federal Employees Retirement System (FERS) • Survivor annuitants under CSRS or FERS • Former spouses • Children and former spouses who are eligible for temporary continuation of coverage
Health Benefits Election Form - GSA
www.gsa.govSuspend your FEHB enrollment (annuitants or former spouses only). Who May Use SF 2809 1. Employees eligible to enroll in or currently enrolled in the FEHB Program. Employees automatically participate in premium conversion unless they waive it, see page 7. 2. Annuitants in retirement systems other than the Civil Service
Health Benefits Election Form - OPM.gov
www.opm.govIf your enrollment is for Self Plus One or Self and Family, complete the family member information as appropriate. (If you need extra space for