Form RI 20-116 RI 20-116 Information about the Cost to Elect Less Than the Maximu

United States
Office of Personnel Management
Washington, DC 20415

OMB Approval 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 your specific written survivor
election 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 your marriage terminates and you want to provide a survivor benefit for a former spouse, you must file a specific
written election with OPM within 2 years after the date of termination of your marriage.
If we can be of further assistance to you, please let us know.
Sincerely,

Legal Administrative Specialist
(202) 936 -________________
Public Burden Statement
The public reporting burden to complete this information collection is estimated at 10 minutes per response, including for reviewing instructions, searching
data sources, gathering and maintaining the data needed, and the completing and reviewing the collected information. An agency may not conduct or
sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection information, including suggestions for reducing this burden to the Office of Personnel
Management, RS Publications Team at [email protected]. Current information regarding this collection of information – including all
background materials -- can be found at https:/www.reginfo.gov/public/do/PRAMain by using the search function to enter either the title of the collection or
OMB Control Number 3206-0174.

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

RI 20-116
Revised October 2024