Ri 20-116 Dc

United States
Office of Personnel Management
Washington, DC 20415

Form approved
OMB Number: 3206-0174

Date

CSA No.

•

This is in response to your request for providing a monthly survivor benefit of $ _________________ for your spouse.
As explained in our previous letter, you may elect a survivor annuity for a spouse you married after retirement. You must
make your election within two (2) years of your marriage. If you make this election, your annuity will be reduced to
reflect the benefit payable to your spouse upon your death.
There will be two reductions to your annuity. The first reduction will be for the regular cost of the survivor benefit. The
reduction may be eliminated should your current marriage end. This reduction is currently $ _________________.
The second reduction is permanent, even if your marriage ends. This reduction is based on your age and difference
between the reduced annuity rate and the annuity rate paid.. This is called an "actuarial" reduction because it is designed
so that the payback is spread out over the average life expectancy of a person your age. If your annuity has not been
reduced for the current survivor election and the actuarial reduction by the effective date, the excess annuity paid may
result in an annuity overpayment. Therefore it is to your advantage to return the election form RI 20-63 as soon as
possible. This reduction is for your remaining lifetime and there is no unpaid balance due after your death. As of this date
the amount is $_________________
Taken together, the reductions to provide a survivor benefit will reduce your current gross annuity from
$_________________ to $_________________.
Note: You have covered your spouse under your Federal Employees Health Benefits enrollment. Your spouse will not be
able to continue the health insurance after your death unless you elect some level of a monthly survivor annuity.
We encourage you to complete and return the decision form as soon as possible. A delay in electing the survivor
annuity benefit will increase the cost of providing a survivor annuity benefit for your new spouse.
If you want to provide a survivor benefit, please complete and return the enclosed application within the time limit. If we
can be of further assistance to you, please let us know.
Sincerely,

Legal Administrative Specialist
(202) 606-___________

Enclosure: RI 20-63 - Survivor Annuity Election for a Spouse

RI 20-116
Revised November 2013