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
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