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Form SF-2809 PDF Fillable

Form SF-2809, also known as the Health Benefits Election Form, is used by federal employees and annuitants (retirees) in the United States to enroll in or make changes to their health benefits plan. It's an important form for managing health insurance coverage for individuals who are part of the Federal Employees Health Benefits (FEHB) Program. Here are the step-by-step instructions on how to fill out Form SF-2809: **Step 1: Download the Form** Visit the official website of the U.S. Office of Personnel Management (OPM) or your federal agency's HR department to download the most current version of Form SF-2809. **Step 2: Identify the Covered Individual** Provide information about the covered individual, which is typically the federal employee, annuitant, or survivor who is eligible for the FEHB coverage. This includes their name, Social Security Number (SSN), date of birth, and retirement claim number (if applicable). **Step 3: Choose Enrollment Type** Indicate whether you are enrolling in a health benefits plan for the first time, changing your plan, or canceling your existing enrollment. **Step 4: Select Health Benefits Plan** Select the health benefits plan you wish to enroll in or make changes to. You will need to provide the plan code and the enrollment code for the specific plan you are choosing. This information can usually be found in the plan's documentation or through your HR department. **Step 5: Provide Contact Information** Fill in the address, phone number, and email address where you can be reached. This information is important for communication regarding your health benefits. **Step 6: Provide Family Information** If you are covering family members under your health benefits plan, provide their information, including names, dates of birth, and relationships. **Step 7: Choose Premium Conversion** Indicate whether you want to participate in the premium conversion program. This program allows you to pay your health insurance premiums with pre-tax dollars, potentially saving you money on taxes. **Step 8: Review and Sign** Review the information you've provided to ensure accuracy. Then, sign and date the form to certify that the information is correct. **Step 9: Submit the Form** Submit the completed SF-2809 form to your federal agency's HR department, benefits office, or the relevant point of contact. This can often be done electronically or by mailing a physical copy of the form. **Important Notes:** - Carefully review the instructions provided on the form and any guidance from your federal agency or HR department. - Ensure that all information provided is accurate and complete before submitting the form. - If you have questions about specific plan codes, enrollment codes, or other details, contact your HR department or the relevant benefits office for assistance. - Keep a copy of the completed form for your records. Remember that the information provided here is a general guide. Always refer to the official instructions on the form and any guidance from your federal agency or HR department for the most accurate and up-to-date instructions.

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This blob was posted on 08-14-2023 it has 49 👀





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