Termination, Conversion and Temporary Continuation of ... - OPM 2026

1. Click ‘Get Form’ to open the Termination, Conversion and Temporary Continuation of ... - OPM form in the editor.
2. Begin by entering the date and your claim number at the top of the form. This information is crucial for processing your request.
3. Carefully read through the instructions provided on the form regarding cancellation or suspension of your FEHBP enrollment. Make sure you understand how your choice affects future eligibility.
4. Select one of the options (A, B, C, D, or E) that best describes your situation. Ensure you check only one box and provide any required documentation as specified.
5. If applicable, fill in your spouse's name and claim number if you are cancelling due to coverage under their plan. Attach necessary forms like SF 2809 if required.
6. Sign and date the form at the bottom to certify that you have read and understood all information related to your decision.
7. Finally, submit the completed form through our platform for processing. Ensure you keep a copy for your records.

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