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  • SF2809 - Health Benefits Election Form
    Federal Employees Receiving Premium Conversion Tax Benefits Table of Permissible Changes in FEHB Enrollment and Premium Conversion Election Premium Conversion allows employees who are eligible for FEHB the opportunity to pay for their share of FEHB premiums with pre-tax dollars
  • Healthcare - U. S. Office of Personnel Management
    PUF filesprovide access to FEHB and FEDVIP Plan, Rate and Benefit Information The Federal Employees Health Benefits (FEHB) Program The FEHB Program can help you and your family meet your health care needs Federal employees, retirees and their survivors enjoy the widest selection of health plans in the country
  • FEHB Handbook - U. S. Office of Personnel Management
    FEHB Program Handbook Introduction General Overview The Federal Employees Health Benefits (FEHB) Program became effective in 1960 It is the largest employer-sponsored group health insurance program in the world, covering over 8 million Federal employees, retirees, former employees, family members, and former spouses
  • Health Benefits Election Form
    Federal Employees Health Benefits Program (FEHB Program) which includes FEHB and Postal Service Health Benefits (PSHB) plans Read the instructions carefully to understand your election and to find the codes referenced in this form
  • Enrollment - U. S. Office of Personnel Management
    Enrollment During the annual FEHB Open Season, anyone eligible to participate in the FEHB Program may enroll, change health plans or options, cancel your FEHB enrollment, and change participation in premium conversion (waive or begin participation)
  • Forms and Brochures - U. S. Office of Personnel Management
    Forms and Brochures Each employing office must keep a supply of the following FEHB forms on hand to meet anticipated needs: Forms for employee use: Health Benefits Election Form (SF 2809) Notice of Change in Health Benefits Enrollment (SF 2810) Temporary Continuation of Coverage (TCC) under the Federal Employees Health Benefits Program (RI 79-27) Forms for employing office use: Report of
  • Eligibility Enrollment - U. S. Office of Personnel Management
    Health Benefits Election Form (SF 2809) (PDF file) If an employee dies, he she will not have an FEHB Self Plus One or Self and Family enrollment for his her survivors to continue, even if he she is eligible for a survivor annuity
  • Form Approved: Employee Health Benefits Election Form
    An individual eligible for temporary continuation of coverage who wants to continue FEHB coverage may choose any plan (for which he or she is eligible), option, and type of enrollment The time limits for a former employee, child, or former spouse to file the SF 2809 with the employing office appear in event number 4A in the table on page 8 Note: If someone other than the enrollee notifies
  • New Federal Employee Enrollment
    Further information on the FEHB Program Federal Employees Health Benefits Program website For assistance in choosing a health plan, see our Plan information pages Detailed guidance for new employees is found in the Eligibility and Election and the Enrollment chapters of the FEHB Handbook
  • Federal Benefits Open Season Manual
    An annual Benefits Administration Letter (BAL) announcing Significant Plan Changes will be issued with pertinent facts about the Federal Employees Health Benefits (FEHB) Program, the Federal Dental and Vision Insurance Program (FEDVIP), and the Federal Flexible Spending Account Program (FSAFEDS), as applicable, providing details for the





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