SF 2809 Federal Employees Health Benefits Program Election Form; OPM 2809 Health Benefits Election Form

ICR 202410-3206-002

OMB: 3206-0160

Federal Form Document

Forms and Documents

Document Name	Status
Form SF 2809 Health Benefits Election Form Form and Instruction	Modified
Health Benefit Election Forms (Supporting Statement Part A)_final.docx Supporting Statement A	2024-10-09
E8-5659.pdf Supplementary Document	2022-04-28
Citations for SF 2809.pdf Supplementary Document	2022-04-28

IC Document Collections

IC ID	Document Title	Status
33632	Health Benefits Election Form Form and Instruction	Modified