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If you have left Federal employment, if you are receiving recurring benefits from the Office of Workers' Compensation Programs, or if you have retired, file this form with the Office of Personnel Management, Retirement Operations Center, Federal Employees Retirement System, P.O. Box 45, Boyers, PA 16017-0045.
They can apply to suspend their coverage at any time. Annuitants can call OPM's Retirement Information Office at 1-888-767-6738 to obtain a suspension form. Callers within the local Washington, DC calling area must call 202-606-0500.
Our number is 888-767-6738 but you may also contact us via email at retire@opm.gov.
If we receive this signed form and documentation within 31 days before to 31 days after the effective date of your Medicaid or similar state-sponsored enrollment, we will suspend your FEHBP coverage at the close of business the day before your Medicaid or state-sponsored program coverage begins.
Form SF-2819 "Notice Form for Conversion Privilege"

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you the form you need to use to confirm this in writing. If you prefer, you can write to us at: U.S. Office of Personnel Management Retirement Operations Center P.O. Box 45 Boyers, PA 16017-0045.
How to file claim with OPM. If you file a claim with OPM, you must file the claim in writing, and you or your duly authorized representative (in writing) must sign your claim. You may submit relevant information to us at any time before we make a decision on your claim.
SF 2810, Notice of Change in Health Benefits Enrollment.

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