Standard Form 2809 ≡ Fill Out Printable PDF Forms Online
Standard Form 2809. Web uses for standard form (sf) 2809 use this form to: Report of withholdings and contributions for health benefits by enrollment code
• switch designated eligible family member; Or suspend your fehb enrollment (annuitants or former spouses only). • enroll or reenroll in the fehb program; Web data standards request form: Or cancel your fehb enrollment; Or change your fehb enrollment from self only to self and family and/or from your present plan or option to another plan or option because of an event described in the table beginning on page 6; Or • cancel your fehb enrollment; Report of withholdings and contributions for health benefits by enrollment code Or • suspend your fehb enrollment (annuitants or former spouses only). •children and former spouses who are eligible for temporary continuation of coverage.
Or cancel your fehb enrollment; By human capital november 1, 2019. Notice of change in health benefits enrollment: Web uses for standard form (sf) 2809 use this form to: Or • elect not to enroll in the fehb program (employees only);or • change your fehb enrollment; Or elect not to enroll in the fehb program (employees only);or change your fehb enrollment; •children and former spouses who are eligible for temporary continuation of coverage. Health benefits registration form (only for use by annuitants and former spouses of annuitants) opm 2810: • enroll or reenroll in the fehb program; Web who may use opm form 2809. •annuitants retired under the civil service retirement system (csrs) or federal employees retirement system (fers) •survivor annuitants under csrs or fers.
