WebUnited States Postal Service ® employees must use PS Form 2976-R, USPS Declaration and Dispatch Note, when gathering package information from all customers mailing international packages (including military mail), that require customs forms at retail windows. WebSince the development of PostalEASE to administer certain employee benefits, the PostalEASE FEHB Worksheet rather than Standard Form (SF) 2809, Health Benefits Election Form, has been used to document election of participation in health benefits except (1) when the person electing benefits is a family member applying for Temporary …
Form Approved: Employee Health Benefits Election …
WebInstructions for Completing OPM 2809 Type or print firmly. Part A — Enrollee and Family Member Information. You must complete this part. Item 1. Enter your legal name. Item 2. … WebMay 3, 2024 · SF 2809, Health Benefits Election Form Part A - Enrollee and Family Member's Information Enter the enrollee name and date of birth at the top of the page. Part B - FEHB Plan You Are Currently Enrolled In (If Applicable) Part C - FEHB Plan You Are Enrolling In or Changing To Part D - Event That Permits You to Enroll, Change, or Cancel check nslc gift card balance
OPM 2809, Health Benefits Election Form - OMB 3206-0141
WebMay 3, 2024 · Standard Form 2809 is used by Federal employees, annuitants other than those under the Civil Service Retirement System (CSRS) and the Federal Employees Retirement System (FERS) including individuals receiving benefits from the Office of Workers' Compensation Programs, former spouses eligible for benefits under the Spouse … WebStandard Form 2809 Revised October 2004 Item 18. If a family member has Medicare, show which Parts he/she has on the line with his/her name. If you complete this form after November 15, 2005, also indicate whether you have pre scription drug coverage under the Medicare Part D program. Item 19. If a family member has TRICARE, see item 8. Check the http://nalcbranch2902.org/download/psforms.pdf flat head denim shirt