WebEnrollment information is usually collected from enrollees through the Health Benefits Election Form (SF Form 2809 (OMB Control Number 3206-0160) or ... OPM 2809 (OMB Control Number 3206-0141)), or electronic equivalent. Information is also collected from agencies through the Notice of Change in Health Benefits Enrollment Form (SF 2810), … WebJun 10, 2015 · A different form (OPM 2809) is used by CSRS and FERS annuitants whose health benefit enrollments are administered by OPM's Retirement Operations. Analysis. Agency: Federal Employee Insurance Operations, Office of Personnel Management. Title: Health Benefits Election Form. OMB Number: 3206-0160. Frequency: On Occasion.
Form Approved: Employee Health Benefits Election Form
WebHealth Benefits Election Form GSA Home GSA Forms Library Search by form number, name or keywords Form: SF2809 Health Benefits Election Form Current Revision Date: 11/2024 Authority or Regulation: Chapter 89, Title 5, U.S. Code DOWNLOAD THIS FORM: Choose a link below to begin downloading. SF2809-19.pdf [PDF - 2 MB ] WebNov 3, 2024 · Sf2809 Health Benefits Election Form. EDITING TEMPLATE Sf2809 Health Benefits Election Form . Help; Finish Help Settings My Documents Log Out ... Management, Retirement Services Publications Team, (3206-0160), Washington, D.C. 20415-3430. The OMB number, 3206-0160 is currently valid. OPM may not melvern casey grand rapids mi
Life Insurance Election Form Approved: OMB No. 3206-0230
Web4. Individuals eligible for Temporary Continuation of Coverage (TCC) under the FEHB Program, including: •Former employees (who separated from service); •Children who lose FEHB coverage; and •Former spouses who are not eligible for FEHB under item 3 above. Form Approved: OMB No. 3206-0160 Instructions for Completing SF 2809 WebUnited States Office of Personnel Management Web3206-0102: HEALTH BENEFITS ELECTION FORM, ANNUITANTS: 3206-0101: ENROLLMENT REPORT, REPORTS NO. 7, 8, AND 9: 3206-0100: PATC - LQB, SPRING 1981 SURVEY: 3206-0099: Initial Certification of Full-time School Attendance: 3206-0098: REQUEST TO INSPECT OR RECEIVE COPIES OF SF 278, FINANCIAL DISCLOSURE … melverley parish council