Form SF 2809, Health Benefits Election Form
Standard Form 2809. Employee health benefits registration form: Instructions for completing opm 2809.
Or elect not to enroll in the fehb program (employees only);or change 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: Or • suspend your fehb enrollment (annuitants or former spouses only). Or • cancel your fehb enrollment; • switch designated eligible family member; Or suspend your fehb enrollment (annuitants or former spouses only). Web health benefits election form. •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);or • change your fehb enrollment; Or change your fehb enrollment from self only to self and family and/or from your present plan or option to another plan or option because of an event described in the table beginning on page 6; Or suspend your fehb enrollment (annuitants or former spouses only). Web health benefits election form. Web health benefits election form form approved: Web data standards request form: Chapter 89, title 5, u.s. Or • suspend your fehb enrollment (annuitants or former spouses only). Or elect not to enroll in the fehb program (employees only); Or • elect not to enroll in the fehb program (employees only);or • change your fehb enrollment; •annuitants retired under the civil service retirement system (csrs) or federal employees retirement system (fers) •survivor annuitants under csrs or fers.
