Web Procedure Manual

Viewing a 2809 Record

The View function allows users to view 2809 records.

To View a 2809 Record:

1. Select the Forms tab on the CLER Federal Employees Health Benefits, Centralized Enrollment Clearinghouse System Main Menu.

   

2. Select the 2809 option at the top on the Form Main page. The Form 2809 page is displayed.

   

3. Complete the following fields on the Form 2809 page:

   Payroll Office ID

   Year

   Quarter

   Agency ID

   POI

   Enrollment Code

   SSN

   User ID

   Last Name

   First Name

   Initial

   Display

   Order By

4. Select the Submit button to confirm all data entered. The Form 2809 search results page is displayed.

   OR

   Select the Reset button to clear all data entered.

   

   The data on the Form 2809 search results page is categorized into the following fields:

   Payroll Office ID

   Year/Quarter

   Enrollee SSN

   Last Name

   First Name

   Release Date

   Released By

   Status

   Options

5. Select the View button next to the applicable record. The Form 2809 View (Part A) page is displayed.

   

   The data on the Form 2809 View page is categorized into the following fields:

   Payroll Office ID

   Year

   Quarter

   Personnel Office ID

   Nature of Action

   The data on the Form 2809 View Part A is categorized into the following fields:

   Last Name

   First Name

   Initial

   Address Line 1

   Address Line 2

   Address Line 3

   City

   State

   Zip

   Foreign Country

   SSN

   Date of Birth

   Sex

   Married

   Other Insurance

   Policyholder Last Name

   Policyholder First Name

   Policyholder Initial

   Medicare You

   Medicare Spouse

   TRICARE/CHAMPUS

   Other

   Name

   Last Changed ID

   Last Changed Date

   Last Changed Time

   Released ID

   Released Date

   Released Time

   Processed Date

   Processed Time

6. Select the Part A Continued option. The Form 2809 View Part A Continued is displayed.

   

   The data on the Form 2809 View Part A Continued is categorized into the following fields:

   Last Name

   First Name

   Initial

   Date of Birth

   Code

   SSN

   Sex

   Zip

7. Select the Parts B through H option to display the Form 2809 View (Parts B through H) page.

   

   The data on the Form 2809 View Part B is categorized into the following fields:

   Present Plan Name

   Present Enrollment Code

   The data on the Form 2809 View Part C is categorized into the following fields:

   New Plan Name

   New Enrollment Code

   The data on the Form 2809 View Part D is categorized into the following fields:

   Event That Permits Change

   Date

   The Form 2809 View Part E field is not applicable to CLER Federal Employees Health Benefits, Centralized Enrollment Clearinghouse System.

   The Form 2809 View Part F field denotes Cancellation = Nature of Transaction STOP.

   The Form 2809 View Part G field is not applicable to CLER Federal Employees Health Benefits, Centralized Enrollment Clearinghouse System.

   The data on the Form 2809 View Part H is categorized into the following fields:

   Date of Action

   Phone

8. Select the Part I option to display the Form 2809 View (Part I) page.

   

   The data on the Form 2809 View Part I is categorized into the following fields:

   Agency Name

   Address Line 1

   Address Line 2

   Address Line 3

   City

   State

   Zip

   Foreign Country

   Agency ID

   Personnel Office ID

   Authorized Official Last Name

   Authorized Official First Name

   Authorized Official Initial

   Contact (Personnel) Last Name

   Contact (Personnel) First Name

   Contact (Personnel) Initial

   Contact (Personnel) Phone

   Contact (Payroll) Last Name

   Contact (Payroll) First Name

   Contact (Payroll) Initial

   Contact (Payroll) Phone

   Effective Date

   Date Received

   Report #

   Remarks

   Note: To view another record, select your browser’s Back button to return to the Form 2809 search results page, then select the View button next to the applicable record.