Health Benefits Election Form

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

OMB: 3206-0160

IC ID: 33632

Documents and Forms

Document Name Document Type
Form SF 2809 Health Benefits Election Form Form and Instruction
SF 2809 Federal Employees Health Benefits Program Election Form Standard From 2809_2024-09-16.docx Form and Instruction
OPM 2809 Health Benefits Election Form OPM2809 Updated_2024_10_09.pdf Form and Instruction