SF 2809, Types of New Enrollments

This topic has been updated to replace SF 2809 with the latest version. The Medicare Claim Number field has been changed to Medicare Beneficiary Identifier.

New enrollment under the Spouse Equity law.

SF 2809, FEHB Health Benefits Election Form Spouse Equity Law

SF 2809, FEHB Health Benefits Election Form, Under the Spouse Equity Law (Part B)

SF2809_Spouse Equity Law_PartB

New enrollment under the TCC law.

SF 2809, FEHB Health Benefits Election Form, Under the TCC Law (Part A)

SF2809_TCC Enrollment_PartB

New enrollment under the DOD-RIF law.

SF 2809, FEHB Health Benefits Election Form, Under the DOD-RIF Law (Part A)

SF2809_DOD_RIF_PartB

Direct Premium Remittance System (DPRS)