E.O. 14168 Request

Non-substantive Change Request OMB Control Number 3206-0160

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

Submitted: 3/14/2025

Summary of request: OPM is submitting a change request to revise questions to align with

E.O. 14168 Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government. OPM is also making additional non-substantive and de minimis changes to enhance forms.

Description of Changes Requested: This request updates sex questions used in SF 2809 and OPM 2809 to be in accordance with E.O. 14168, and it makes additional non-substantive and de minimis changes to enhance forms. Please check the boxes below if your request includes:

☒Revision of an existing question(s)

• Deletion of an existing question(s)

Description of Changes to Burden – no change

Form	Approved Burden	Requested Burden
SF 2809	9,000 hours 0.50 hours per response for 18,000 respondents	9,000 hours 0.50 hours per response for 18,000 respondents
OPM 2809 (written)	10,000 hours 0.50 hours per response for 20,000 respondents	10,000 hours 0.50 hours per response for 20,000 respondents
OPM 2809 (verbal)	1667 hours 0.1667 hours per response for 10,000 respondents	1667 hours 0.1667 hours per response for 10,000 respondents
Total	20,667 hours	20,667 hours

Other Considerations: Urgent request – agencies are already asking OPM about revisions.

Table A: Description of Changes

Form	Type of Change	Question/Item	Requested Change
SF 2809	Question Revision	Part A, item 7 Part C, item d	Remove “prefer not to answer” as third option in sex dropdown menu choice. Explain in instructions “You must select the option that corresponds with your biological sex at birth.” This change aligns with E.O. 14168.
SF 2809	Question Revision	Part A, item 9	For enrollee category dropdown menu, change “Annuitant” option to “Annuitant other than CSRS or FERS”. This change aligns with the content of the “Who May Use the SF 2809” section on form’s first page.
SF 2809	Question Revision	Part A, item 10 Part C, item f	Revise the text for two answer choices in response to questions asking whether an enrollee or family member is claiming an exception to the Medicare Part B enrollment requirement. Specifically, one answer choice reads, “USPS Medicare covered annuitant not enrolled in Medicare Part B on or before January 1, 2025.” The term “on or before” was changed to just “on.” The answer choice now reads, “USPS Medicare covered annuitant not enrolled in Medicare Part B on January 1, 2025.” Similarly, a second answer choice currently reads, “USPS employee who is at least 64 years of age or older on or before January 1, 2025.” Again, the term “on or before” was changed to just “on.” The answer choice now reads, “USPS employee who is at least 64 years of age or older on January 1, 2025.”
SF 2809	Instruction Revision	Part A, item 10 Part C, item f	Revise the instructions for item 10 and item f. All that is needed is text indicating “Individuals eligible to enroll in Medicare Part A under section 1818 or section 1818A are not subject to the Medicare Part B requirement.” Remove text indicating “USPS employees can also report family members with eligibility to enroll in Medicare Part A under Section 1818 or 1818A. Medicare Part A enrollment under Section 1818 or 1818A applies to individuals who (1) pay the full premium for Part A because they are not insured for Medicare Part A and are over age 65 or (2) pay the full premium for Part A because they are no longer entitled to Social Security disability benefits but chose to continue Medicare coverage beyond the disability termination date.” The first sentence is redundant with other text. The second sentence is describing requirements outside of OPM’s authority.
SF 2809	Instruction Revision	Part A, Item 10	Revise the instruction for item 10 so that the term “recognized natural child” is changed to “biological child” to align with usage elsewhere in the form.
OPM 2809	Instruction Revision	Part A, Item 4	Revising the instruction for item 4 from “Enter your sex.” to “You must select a sex option “Male” or “Female” that corresponds with your biological sex at birth.” This change aligns with Executive Order 14168.
OPM 2809	Instruction Revision	Part A, Item 10, (4)	Revising a specific part of the text in this section to align with regulatory text regarding an enrollee claiming an exception to the Medicare Part B enrollment requirement is changed from, “Enrollee not required to enroll – Postal Service Medicare covered annuitant who was not both entitled to Medicare Part A and enrolled in Part B on or before January 1, 2025 or was a Postal Service employee who was at least 64 years of age or older on or before January 1, 2025; or...” to “Enrollee not required to enroll – Postal Service Medicare covered annuitant who was not both entitled to Medicare Part A and enrolled in Part B on January 1, 2025, or was a Postal Service employee who was at least 64 years of age or older on January 1, 2025; or...”
OPM 2809	Instruction Revision	Part B, Item 16	Revising the instruction for item 16 from “Provide the sex of the family member.” to “You must select a sex option “Male” or “Female” that corresponds with the biological sex at birth of your family member.” This change aligns with Executive Order 14168.
OPM 2809	Instruction Revision	Part B, Item 22, (4)	Revising a specific part of the text in this section to align with regulatory text regarding whether an enrollee or family member is claiming an exception to the Medicare Part B enrollment requirement is changed from, “Enrollee not required to enroll – Postal Service Medicare covered annuitant who was not both entitled to Medicare Part A and enrolled in Part B on or before January 1, 2025 or was a Postal Service employee who was at least 64 years of age or older on or before January 1, 2025; or...” to “Enrollee not required to enroll – Postal Service Medicare covered annuitant who was not both entitled to Medicare Part A and enrolled in Part B on January 1, 2025, or was a Postal Service employee who was at least 64 years of age or older on January 1, 2025; or...”
OPM 2809	Instruction Revision	Part B, Item 22, (5)	Corrected an incorrect reference of “181A” to “1818A” which revised, “Medicare A-Section 1818 or 181A of the Social Security Act [42 U.S.C. 1395i-2, 1395i-2a...” to “Medicare A-Section 1818 or 1818A of the Social Security Act [42 U.S.C. 1395i-2, 1395i-2a...”
OPM 2809	Instruction Revision	Part B, Family Members Eligible for Coverage, 2nd Paragraph	Revising the instruction within the 2nd paragraph so that the term “recognized natural child” is changed to “biological child” to align with usage shown within prior Part A, Item 4, and Part B, Item 16 on the instruction section. This change aligns with Executive Order 14168.
OPM 2809	Instruction Revision	Part B, Family Members Eligible for Coverage, 4th Paragraph	Revising the instruction within the 4th paragraph so that the term “natural child” is changed to “biological child” to align with usage shown within prior Part A, Item 4, and Part B, Item 16 on the instruction section. This change aligns with Executive Order 14168.
OPM 2809	Instruction Revision	Part F, 1st Paragraph	Revising the instructions within the 1st paragraph so the term “INITIAL” is changed to “SELECT” to align with usage shown in the subsequent question section of Part F.
OPM 2809	Instruction Revision	Part F, 5th Paragraph	Revising the instructions within the 5th paragraph so the term “INITIAL” is changed to “SELECT” to align with usage shown in the subsequent question section of Part F.
OPM 2809	QLE Table Revision	QLE 2I, Event Description, Page 7	Corrected to replace “further” with “farther” so that the sentence reads, “Annuitant or covered family member in a Health Maintenance Organization (HMO) moves outside the geographic area from which the carrier accepts enrollments, or if already outside this area, moves farther from this area.”
OPM 2809	QLE Table Revision	QLE 3I, Event Description, Page 8	Corrected to replace “further” with “farther” so that the sentence reads, “Former spouse or covered family member in a Health Maintenance Organization (HMO) moves outside the geographic area from which the carrier accepts enrollments, or if already outside this area, moves farther from this area.”
OPM 2809	QLE Table Revision	QLE 4H, Event Description, Page 9	Corrected to replace “further” with “farther” so that the sentence reads, “Enrollee or covered family member in a Health Maintenance Organization (HMO) moves outside the geographic area from which the carrier accepts enrollments, or if already outside this area, moves farther from this area.”
OPM 2809	QLE Table Revision	QLE 5J, Event Description, Page 10	Corrected to replace “further” with “farther” so that the sentence reads, “Employee or covered family member in a Health Maintenance Organization (HMO) moves or becomes employed outside the geographic area from which the carrier accepts enrollments, or if already outside the area, moves or becomes employed farther from this area.”
OPM 2809	Question Revision	Part A, item 4	Removed the 3rd response option, “Prefer not to answer”, from the request to provide the Sex type. The revision now reflects just two response options, “Male” or “Female”. This change aligns with Executive Order 14168.
OPM 2809	Question Revision	Part B, items 16, 28, and 40	Removed the 3rd response option, “Prefer not to answer”, from the request to provide the Sex type. The revision now reflects just two response options, “Male” or “Female”. This change aligns with Executive Order 14168.
OPM 2809	Question Revision	Part B, 2nd radio button of items 22, 34, and 46	Correcting an incorrect cross-reference within the document from “See instructions for item 10 on page 1” to “See instructions for item 22 on page 2.”
OPM 2809	Instruction Revision	Part F, Subject	Revising the instructions for clarity by replacing “Fill in” with “Complete” so that the language is updated to, “(Complete this part if you wish to suspend/cancel your enrollment in the FEHB Program. See pages 3 – 4 of the instructions.)”
OPM 2809	Question Revision	Part F	For additional clarity and accuracy, revised the applicant’s statement to replace “initialed” with “selected" so that it reads, “I elect to suspend or cancel my enrollment and have selected the appropriate box below.” This change will align with Part F within the instruction section.
OPM 2809	Instruction Revision	Part G	Revising the instructions for clarity by replacing “fill in” with “complete” so that the language is updated to, “(you must complete this part)”