Benefits (Standard Form 2800 or the equivalent) should be filed promptly to avoid any question about health benefits coverage. When the survivor annuity is approved, another form like this one will be issued to show that the enrollment is being continued in …

SF 2810, Notice of Change in Health Benefits Enrollment. See Appendix III, Instructions on Completing the SF 2810, for the instructions on completing the SF 2810 form.

Employing offices obtain Standard Forms 2809 and 2810 directly from GSA supply centers, just as they do other OPM Standard Forms. Agencies do not need to maintain an internal procurement and distribution network for FEHB forms.

The Forms Library is a representation of the OPM Master Forms List. For your convenience, the mostly used (Top Forms) are made available for download. Also available for export is the Master Forms List. Please use the Master Forms List in conjunction with the Indexing Guide found on the Toolkit under Implementation.

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Standard Form 2810 Notice of Change in Health Benefits Enrollment. This section includes instructions and definitions of the fields on SF 2810. The following fields are available on the Standard Form 2810, Notice of Change in Health Benefits Enrollment form: Address Line - Enrollee. Enter the enrollee's address. Agency Address. Enter the Agency ...

Apr 19, 2018 · To transfer out of Employment, Retirement, Death, and Employees' Compensation, the following forms are required: Note: The Agencies need to include the original SF 2809, Health Benefits Election Form. The Agencies must verify the address and phone number on the original SF 2809 for accuracy.

This form covers health benefits actions except enrollments, changes from one plan to another, changes of coverage within a plan, and cancellations, all of which are processed on the Health Benefits Registration Form (OPM Form 2809).

Feb 21, 2025 · Direct Premium Remittance System (DPRS) The DPRS system provides an enrollment, billing, and collection process for Federal Employee Health Benefits (FEHB) for eligible separated Federal employees, former spouses of Federal employees, dependents of Federal employees, direct pay annuitants, and dependents of annuitants. I Want to ...

The FECA program cannot accept Form SF 2809 (Health Benefits Election Form) or Form SF 2810 (Notice of Change in Health Benefits Enrollment) for any Postal Service claimant. All changes must be processed through OPM’s PSHB system.