Direct Premium Remittance System (DPRS)

Who May Use an SF 2809

1. Employees eligible to enroll in or currently enrolled in the FEHB Program, including temporary employees eligible under 5 United States Code (U.S.C.) 8906a. Employees automatically participate in premium conversion unless they waive it.
2. Annuitants in retirement systems other than the Civil Service Retirement System (CSRS) or Federal Employees Retirement System (FERS), including individuals receiving monthly compensation from the Office of Workers' Compensation Programs (OWCP).

   Note: CSRS and FERS annuitants and former spouses and children of CSRS/FERS annuitants - do not use this form. Instead, use OPM 2809, Health Benefits Registration Form (only for use by Annuitants and Former Spouses of Annuitants), which is available at www.opm.gov/retire, or call the Retirement Information Office toll free at 1-888-767-6738.

3. Former spouses eligible to enroll in or currently enrolled in the FEHB Program under the Spouse Equity law or similar statutes.
4. Individuals eligible for TCC under the FEHB Program, including:
   • Former employees (who separated from service)
   • Children who lose FEHB coverage
   • Former spouses who are not eligible for FEHB under the Spouse Equity law or similar statutes