Sf 2809 form opm-2025

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The Health Benefits Election Form (SF 2809) is used by federal employees and annuitants to manage their enrollment in the Federal Employees Health Benefits (FEHB) Program. It allows users to switch family members, enroll or reenroll, change, cancel, or suspend their FEHB enrollment. The form includes sections for personal information, current and desired health plans, and details about qualifying life events that permit changes in enrollment. It also outlines eligibility criteria for various groups including employees, annuitants, former spouses, and individuals eligible for Temporary Continuation of Coverage (TCC). Additionally, it provides instructions on completing the form and emphasizes the importance of accurate information for processing health benefits.

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Click ‘Get Form’ to open the SF 2809 in our platform's editor.
Begin with Part A, where you will enter your personal information including your name, Social Security Number, and date of birth. Ensure accuracy as this information is crucial for your health benefits.
In Item 5, indicate your marital status and provide your home mailing address in Item 6. If applicable, check if you are covered by Medicare in Items 7 and 8.
Proceed to list any other insurance coverage in Item 10. This is important for determining eligibility for FEHB enrollment.
Complete the family member information section if enrolling dependents. Provide their details accurately, including Social Security Numbers and relationship codes.
In Part B, specify the FEHB plan you are currently enrolled in. If changing plans, fill out Part C with the new plan details.
For any changes or cancellations, complete Parts D through G as necessary. Make sure to sign in Part H to authorize the changes.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (82 Votes)
2015	4.3 Satisfied (340 Votes)
2014	4.4 Satisfied (802 Votes)
2011	4 Satisfied (24 Votes)
2011	4.4 Satisfied (226 Votes)
2004	4 Satisfied (49 Votes)

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How do I opt out of FEHb?

Removing FEHB Benefits Click the Other Government Programs tab. Click Remove. The option to remove an FEHB benefit is not available if the Start Date is more than 90 days in the past. Click Remove again to confirm your selection or click Cancel to leave the FEHB benefits unchanged.

How to get sf 75?

How to get a blank Form SF 75? To get a blank SF 75, visit our website where the form is pre-loaded and ready for you to fill. This form is issued by the U.S. Office of Personnel Management (OPM).

How does FEHb work?

FEHB Program carriers cover most active, full-time civilian employees and retirees of the U.S. government and their families. The Program now provides benefits to nearly 8.3 million federal enrollees and dependents and offers our 180 health plan choices to federal members.