Opportunities to Enroll or Change Enrollment

Now or Newly Eligible Employees:

You are required to complete a Health Benefits Registration Form (Standard Form SF2809) obtained from your employing office. You must indicate on the form whether you want to enroll or do not want to enroll in an FEHB plan.

You must return the completed SF 2809 to your employing office:

Within 31 days after:.................................If you are a:

Your date of appointment........................................New employee.

The date you become eligible to enroll.................. Newly eligible employee.

All Eligible Employees:

If you are not enrolled, you will be able to enroll only when an event permitting enrollment occurs. Such events, which are listed in the section titled "Table of Permissible Changes" include (but are not limited to) --

• Open-Season.
• Change in marital status.
• Loss of coverage as a family member under FEHB.
• Loss of coverage under spouse's non-Federal health plan if spouse Involuntarily loses his or her coverage or coverage for his or her dependents.

If you are enrolled, you may change your enrollment only when an event permitting the change you want to make occurs see section titled "Table of Permissible Changes". However, you may change from self and family to self only at any time.

To enroll or change your enrollment, obtain an SF 2809 from your employing office, complete the form and return it to your employing office within the time limit specified in the section titled, "Table of Permissible Changes".

**Note:You will not be eligible for health benefits coverage after retirement unless you are enrolled before you retire and meet all the requirements for continuation of enrollment after retirement see section titled "Circumstances Permitting Continuation of Enrollment".