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Viewing a 2809 Record

The View function allows users to view 2809 records.

To View a 2809 Record:

  1. Select the Forms tab at the top of the CLER Main Menu. The Forms Main Page is displayed with the options 2809 and 2810.

    Forms Main page

  2. Select the 2809 option on the Forms Main Page. The Form 2809 page is displayed.

    2809 Form page 1

  3. Complete the fields as follows:

    Field

    Instruction

    Payroll Office ID*

    Required

    Select the payroll office identification number from the drop-down menu.

    Year*

    Optional, default

    Select the reconciliation year from the drop-down menu. If no year is selected, this field automatically defaults to the current reconciliation year.

    Quarter*

    Optional, default

    Select the reconciliation quarter from the drop-down menu. If no quarter is selected, this field automatically defaults to the current reconciliation quarter.

    Agency ID

    Optional, alphanumeric, 4 positions

    Enter the Agency identification code for the enrollee's employing, personnel, or point of contact office (example: AG90 for U.S. Department of Agriculture, Office of the Chief Financial Officer).

    POI

    Optional, alphanumeric, 4 positions

    Enter the personnel office identification number where the enrollee's records are maintained.

    Enrollment Code

    Optional, alphanumeric, 3 positions

    Enter the enrollment/carrier enrollment code.

    SSN

    Required, alphanumeric, 9 positions

    Enter the enrollee’s Social Security number (SSN). If the enrollee does not want his/her SSN provided to the carrier, a pseudo SSN may be used if the pseudo SSN is also reported to CLER.

    User ID

    Optional, alphanumeric, 8 positions maximum

    Enter the user identification number of the person creating the form.

    Last Name

    Optional, alphanumeric, 25 positions maximum

    Enter the enrollee’s last name. If the enrollee has a title (e.g., Jr, Sr, I, II, or III), it should be entered after the last name without punctuation (e.g., Smith Jr or Smith III). If there is a case of an enrollee having only one name, enter that one name in this field.

    First Name

    Optional, alphanumeric, 17 positions maximum

    Enter the enrollee’s first name.

    Initial

    Optional, alphanumeric, 1 position

    Enter the enrollee’s middle initial.

    Display

    Optional, default

    Defaults to the All display option. Allows users to display search results by the options listed below. To choose another display option, select the radio button next to one of the following options:

    All - Displays all records related to the search criteria.

    Released - Displays records released for processing.

    Cancelled - Displays records that have been cancelled.

    Not Released - Displays records not released for processing.

    Processed - Displays processed records.

    Order By

    Optional, default

    Defaults to the Agency ID sort option. Allows users to sort search results by the options listed below. To choose another sort option, select the radio button next to one of the following options:

    Agency ID - Search by Agency identification code.

    SSN - Search by enrollee Social Security number.

    Name - Search by enrollee name.

    User ID - Search by user identification number.

    Status - Search by status (e.g., released, processed, not released, or cancelled release).

  4. Click Submit. The Form 2809 Results page is displayed.

    Form 2809 Search Results page

    Field

    Description

    Payroll Office ID

    System generated

    Displays the payroll office identification number.

    Year

    System generated

    Displays the reconciliation year.

    Quarter

    System generated

    Displays the reconciliation quarter.

    Enrollee SSN

    System generated

    Displays the enrollee’s SSN.

    Last Name

    System generated

    Displays the enrollee’s last name.

    First Name

    System generated

    Displays the enrollee’s first name.

    Release Date

    System generated

    Displays the date the record was released for processing.

    Released By

    System generated

    Displays the user identification number of the individual who released the record for processing.

    Status

    System generated

    Displays the status of the transmission. This field is populated by one of the following: Processed, Canceled, Released, or Not Released.

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

    Form 2809 View  Part A Page

    Field

    Description

    Payroll Office ID

    System generated

    Displays the payroll office identification number.

    Year

    System generated

    Displays the reconciliation year.

    Quarter

    System generated

    Displays the reconciliation quarter.

    Personnel Office ID

    System generated

    Displays the personnel office identification number.

    Nature of Action

    System generated

    A selected radio button indicates:

    Start - Enrollment in FEHB.

    Change - Change to a current FEHB enrollment.

    Suspend - Suspension of FEHB enrollment.

    Stop - Cancelation of FEHB enrollment.

    Last Name

    System generated

    Displays the enrollee’s last name.

    First Name

    System generated

    Displays the enrollee’s first name.

    Initial

    System generated

    Displays the enrollee’s middle initial.

    Address Line 1

    System generated

    Displays the first line of the enrollee’s domestic or foreign street, apartment number, or post office box, rural route, etc.

    Address Line 2

    System generated

    Displays the second line of the enrollee’s domestic or foreign street, apartment number, or post office box, rural route, etc.

    Address Line 3

    System generated

    Displays the third line of the enrollee’s domestic or foreign street, apartment number, or post office box, rural route, etc.

    City

    System generated

    Displays the name of the enrollee’s domestic or foreign city.

    Note: If the address is an overseas military address, this field displays FPO for fleet post office or APO for army post office in lieu of the city.

    State

    System generated

    Displays the enrollee's State, U.S. territory, or overseas military abbreviation. For a list and descriptions of State, U.S. territory, and overseas military abbreviations, see State, U.S. Territory, and Overseas Military Abbreviations Table.

    Zip

    System generated

    Displays the enrollee's domestic or foreign ZIP Code or foreign postal code.

    Country

    System generated

    Displays the enrollee’s country code. For a list and descriptions of country codes, see Country Codes Table.

    SSN

    System generated

    Displays the enrollee’s SSN.

    Date of Birth

    System generated

    Displays the enrollee’s date of birth.

    Sex

    The selected radio button indicates the following values:

    M - Male

    F - Female

    Married

    The selected radio button indicates the following values:

    Y - Enrollee is married.

    N - Enrollee is single.

    Phone

    System generated

    Displays the enrollee's daytime area code and telephone number.

    Last Changed ID

    System generated

    Displays the user identification number of the individual who made the most recent change to the record.

    Last Changed Date

    System generated

    Displays the date of the most recent change.

    Last Changed Time

    System generated

    Displays the time of the most recent change.

    Released ID

    System generated

    Displays the user identification number of the individual who released the record for processing.

    Released Date

    System generated

    Displays the date the record was released for processing.

    Released Time

    System generated

    Displays the time the record was released for processing.

    Processed Date

    System generated

    Displays the date the record was processed.

    Processed Time

    System generated

    Displays the time the record was processed.

  6. Select the Part A Continued option at the top of the Form 2809 View (Part A) page. The Form 2809 View (Part A Continued) page is displayed.

    Form 2809 View Page Part A Continued

    Field

    Description

    Last Name Line 1

    System generated

    Displays the last name of the enrollee's first family member who is enrolled/enrolling in FEHB.

    First Name Line 1

    System generated

    Displays the first name of the enrollee's first family member who is enrolled/enrolling in FEHB.

    Initial Line 1

    System generated

    Displays the middle initial of the enrollee’s first family member who is enrolled/enrolling in FEHB.

    Date of Birth Line 1

    System generated

    Displays the date of birth (MMDDYYYY) of the enrollee’s first family member who is enrolled/enrolling in FEHB.

    Code Line 1

    System generated

    Displays the code that identifies the first family member's relation to the enrollee.The codes are:

    01 - Spouse

    09 - Adopted child

    10 - Foster child

    17 - Stepchild

    19 - Unmarried dependent child under age 22

    99 - Eligible unmarried disabled child over 22

    SSN Line 1

    System generated

    Displays the SSN of the enrollee’s first family member who is enrolled/enrolling in FEHB.

    Sex Line 1

    The values listed below indicate the following:

    M - Indicates the enrollee is male.

    F - Indicates the enrollee is female.

    Zip Line 1

    System generated

    Displays the Zip Code or foreign postal code of the enrollee’s first family member who is enrolled/enrolling in FEHB.

    Last Name Line 2

    System generated

    Displays the last name of the enrollee's second family member who is enrolled/enrolling in FEHB.

    First Name Line 2

    System generated

    Displays the first name of the enrollee's second family member who is enrolled/enrolling in FEHB.

    Initial Line 2

    System generated

    Displays the middle initial of the enrollee’s second family member who is enrolled/enrolling in FEHB.

    Date of Birth Line 2

    System generated

    Displays the date of birth (MMDDYYYY) of the enrollee’s second family member who is enrolled/enrolling in FEHB.

    Code Line 2

    System generated

    Displays the code that identifies the second family member's relation to the enrollee.The codes are:

    01 - Spouse

    09 - Adopted child

    10 - Foster child

    17 - Stepchild

    19 - Unmarried dependent child under age 22

    99 - Eligible unmarried disabled child over 22

    SSN Line 2

    System generated

    Displays the SSN of the enrollee’s second family member who is enrolled/enrolling in FEHB.

    Sex Line 2

    The values listed below indicate the following:

    M - Indicates the enrollee is male.

    F - Indicates the enrollee is female.

    Zip Line 2

    System generated

    Displays the Zip Code or foreign postal code of the enrollee’s second family member who is enrolled/enrolling in FEHB.

    Last Name Line 3

    System generated

    Displays the last name of the enrollee's third family member who is enrolled/enrolling in FEHB.

    First Name Line 3

    System generated

    Displays the first name of the enrollee's third family member who is enrolled/enrolling in FEHB.

    Initial Line 3

    System generated

    Displays the middle initial of the enrollee’s third family member who is enrolled/enrolling in FEHB.

    Date of Birth Line 3

    System generated

    Displays the date of birth (MMDDYYYY) of the enrollee’s third family member who is enrolled/enrolling in FEHB.

    Code Line 3

    System generated

    Displays the code that identifies the third family member's relation to the enrollee.The codes are:

    01 - Spouse

    09 - Adopted child

    10 - Foster child

    17 - Stepchild

    19 - Unmarried dependent child under age 22

    99 - Eligible unmarried disabled child over 22

    SSN Line 3

    System generated

    Displays the SSN of the enrollee’s third family member who is enrolled/enrolling in FEHB.

    Sex Line 3

    The values listed below indicate the following:

    M - Indicates the enrollee is male.

    F - Indicates the enrollee is female.

    Zip Line 3

    System generated

    Displays the Zip Code or foreign postal code of the enrollee’s third family member who is enrolled/enrolling in FEHB.

    Last Name Line 4

    System generated

    Displays the last name of the enrollee's fourth family member who is enrolled/enrolling in FEHB.

    First Name Line 4

    System generated

    Displays the first name of the enrollee's fourth family member who is enrolled/enrolling in FEHB.

    Initial Line 4

    System generated

    Displays the middle initial of the enrollee’s fourth family member who is enrolled/enrolling in FEHB.

    Date of Birth Line 4

    System generated

    Displays the date of birth (MMDDYYYY) of the enrollee’s fourth family member who is enrolled/enrolling in FEHB.

    Code Line 4

    System generated

    Displays the code that identifies the fourth family member's relation to the enrollee.The codes are:

    01 - Spouse

    09 - Adopted child

    10 - Foster child

    17 - Stepchild

    19 - Unmarried dependent child under age 22

    99 - Eligible unmarried disabled child over 22

    SSN Line 4

    System generated

    Displays the SSN of the enrollee’s fourth family member who is enrolled/enrolling in FEHB.

    Sex Line 4

    The values listed below indicate the following:

    M - Indicates the enrollee is male.

    F - Indicates the enrollee is female.

    Zip Line 4

    System generated

    Displays the Zip Code or foreign postal code of the enrollee’s fourth family member who is enrolled/enrolling in FEHB.

    Last Name Line 5

    System generated

    Displays the last name of the enrollee's fifth family member who is enrolled/enrolling in FEHB.

    First Name Line 5

    System generated

    Displays the first name of the enrollee's fifth family member who is enrolled/enrolling in FEHB.

    Initial Line 5

    System generated

    Displays the middle initial of the enrollee’s fifth family member who is enrolled/enrolling in FEHB.

    Date of Birth Line 5

    System generated

    Displays the date of birth (MMDDYYYY) of the enrollee’s fifth family member who is enrolled/enrolling in FEHB.

    Code Line 5

    System generated

    Displays the code that identifies the fifth family member's relation to the enrollee.The codes are:

    01 - Spouse

    09 - Adopted child

    10 - Foster child

    17 - Stepchild

    19 - Unmarried dependent child under age 22

    99 - Eligible unmarried disabled child over 22

    SSN Line 5

    System generated

    Displays the SSN of the enrollee’s fifth family member who is enrolled/enrolling in FEHB.

    Sex Line 5

    The values listed below indicate the following:

    M - Indicates the enrollee is male.

    F - Indicates the enrollee is female.

    Zip Line 5

    System generated

    Displays the Zip Code or foreign postal code of the enrollee’s fifth family member who is enrolled/enrolling in FEHB.

    Last Name Line 6

    System generated

    Displays the last name of the enrollee's sixth family member who is enrolled/enrolling in FEHB.

    First Name Line 6

    System generated

    Displays the first name of the enrollee's sixth family member who is enrolled/enrolling in FEHB.

    Initial Line 6

    System generated

    Displays the middle initial of the enrollee’s sixth family member who is enrolled/enrolling in FEHB.

    Date of Birth Line 6

    System generated

    Displays the date of birth (MMDDYYYY) of the enrollee’s sixth family member who is enrolled/enrolling in FEHB.

    Code Line 6

    System generated

    Displays the code that identifies the sixth family member's relation to the enrollee.The codes are:

    01 - Spouse

    09 - Adopted child

    10 - Foster child

    17 - Stepchild

    19 - Unmarried dependent child under age 22

    99 - Eligible unmarried disabled child over 22

    SSN Line 6

    System generated

    Displays the SSN of the enrollee’s sixth family member who is enrolled/enrolling in FEHB.

    Sex Line 6

    The values listed below indicate the following:

    M - Indicates the enrollee is male.

    F - Indicates the enrollee is female.

    Zip Line 6

    System generated

    Displays the Zip Code or foreign postal code of the enrollee’s sixth family member who is enrolled/enrolling in FEHB.

    Last Name Line 7

    System generated

    Displays the last name of the enrollee's seventh family member who is enrolled/enrolling in FEHB.

    First Name Line 7

    System generated

    Displays the first name of the enrollee's seventh family member who is enrolled/enrolling in FEHB.

    Initial Line 7

    System generated

    Displays the middle initial of the enrollee’s seventh family member who is enrolled/enrolling in FEHB.

    Date of Birth Line 7

    System generated

    Displays the date of birth (MMDDYYYY) of the enrollee’s seventh family member who is enrolled/enrolling in FEHB.

    Code Line 7

    System generated

    Displays the code that identifies the seventh family member's relation to the enrollee.The codes are:

    01 - Spouse

    09 - Adopted child

    10 - Foster child

    17 - Stepchild

    19 - Unmarried dependent child under age 22

    99 - Eligible unmarried disabled child over 22

    SSN Line 7

    System generated

    Displays the SSN of the enrollee’s seventh family member who is enrolled/enrolling in FEHB.

    Sex Line 7

    The values listed below indicate the following:

    M - Indicates the enrollee is male.

    F - Indicates the enrollee is female.

    Zip Line 7

    System generated

    Displays the Zip Code or foreign postal code of the enrollee’s seventh family member who is enrolled/enrolling in FEHB.

    Last Name Line 8

    System generated

    Displays the last name of the enrollee's eighth family member who is enrolled/enrolling in FEHB.

    First Name Line 8

    System generated

    Displays the first name of the enrollee's eighth family member who is enrolled/enrolling in FEHB.

    Initial Line 8

    System generated

    Displays the middle initial of the enrollee’s eighth family member who is enrolled/enrolling in FEHB.

    Date of Birth Line 8

    System generated

    Displays the date of birth (MMDDYYYY) of the enrollee’s eighth family member who is enrolled/enrolling in FEHB.

    Code Line 8

    System generated

    Displays the code that identifies the eighth family member's relation to the enrollee.The codes are:

    01 - Spouse

    09 - Adopted child

    10 - Foster child

    17 - Stepchild

    19 - Unmarried dependent child under age 22

    99 - Eligible unmarried disabled child over 22

    SSN Line 8

    System generated

    Displays the SSN of the enrollee’s eighth family member who is enrolled/enrolling in FEHB.

    Sex Line 8

    The values listed below indicate the following:

    M - Indicates the enrollee is male.

    F - Indicates the enrollee is female.

    Zip Line 8

    System generated

    Displays the Zip Code or foreign postal code of the enrollee’s eighth family member who is enrolled/enrolling in FEHB.

    Last Name Line 9

    System generated

    Displays the last name of the enrollee's ninth family member who is enrolled/enrolling in FEHB.

    First Name Line 9

    System generated

    Displays the first name of the enrollee's ninth family member who is enrolled/enrolling in FEHB.

    Initial Line 9

    System generated

    Displays the middle initial of the enrollee’s ninth family member who is enrolled/enrolling in FEHB.

    Date of Birth Line 9

    System generated

    Displays the date of birth (MMDDYYYY) of the enrollee’s ninth family member who is enrolled/enrolling in FEHB.

    Code Line 9

    System generated

    Displays the code that identifies the ninth family member's relation to the enrollee.The codes are:

    01 - Spouse

    09 - Adopted child

    10 - Foster child

    17 - Stepchild

    19 - Unmarried dependent child under age 22

    99 - Eligible unmarried disabled child over 22

    SSN Line 9

    System generated

    Displays the SSN of the enrollee’s ninth family member who is enrolled/enrolling in FEHB.

    Sex Line 9

    The values listed below indicate the following:

    M - Indicates the enrollee is male.

    F - Indicates the enrollee is female.

    Zip Line 9

    System generated

    Displays the Zip Code or foreign postal code of the enrollee’s ninth family member who is enrolled/enrolling in FEHB.

    Last Name Line 10

    System generated

    Displays the last name of the enrollee's tenth family member who is enrolled/enrolling in FEHB.

    First Name Line 10

    System generated

    Displays the first name of the enrollee's tenth family member who is enrolled/enrolling in FEHB.

    Initial Line 10

    System generated

    Displays the middle initial of the enrollee’s tenth family member who is enrolled/enrolling in FEHB.

    Date of Birth Line 10

    System generated

    Displays the date of birth (MMDDYYYY) of the enrollee’s tenth family member who is enrolled/enrolling in FEHB.

    Code Line 10

    System generated

    Displays the code that identifies the tenth family member's relation to the enrollee.The codes are:

    01 - Spouse

    09 - Adopted child

    10 - Foster child

    17 - Stepchild

    19 - Unmarried dependent child under age 22

    99 - Eligible unmarried disabled child over 22

    SSN Line 10

    System generated

    Displays the SSN of the enrollee’s tenth family member who is enrolled/enrolling in FEHB.

    Sex Line 10

    The values listed below indicate the following:

    M - Indicates the enrollee is male.

    F - Indicates the enrollee is female.

    Zip Line 10

    System generated

    Displays the Zip Code or foreign postal code of the enrollee’s tenth family member who is enrolled/enrolling in FEHB.

  7. Select the Parts B-H option at the top of the Form 2809 View (Part A Continued) page. The Form 2809 View (Parts B-H) page is displayed.

    Form 2809 View Page Part B H

    Field

    Description

    Present Plan Name

    System generated

    Displays the name of the FEHB health insurance plan in which the enrollee is currently enrolled.

    Present Enrollment Code

    System generated

    Displays the name of the enrollment code which the enrollee is currently enrolled.

    New Plan Name

    System generated

    Displays the new FEHB health insurance plan name.

    New Enrollment Code

    System generated

    Displays the new enrollment code.

    Event That Permits Change

    System generated

    Displays the FEHB Event Code that identifies the event that initiated the enrollee's action. Refer to SF 2809 or OPM 2809 for a list of Event Codes.

    Date

    System generated

    Displays the date (MMDDYYYY) of the event that initiated the enrollee's action.

    Date of Action

    System generated

    Displays the date (MMDDYYYY) the enrollee made this election.

    Phone

    System generated

    Displays the enrollee's daytime area code and telephone number.

  8. Select the Part I option at the top of the Form 2809 View (Parts B-H) page. The Form 2809 View (Part I) page is displayed.

    Form 2809 View Page Part I

    Field

    Description

    Agency Name

    System generated

    Displays the name of the employing, personnel, or point of contact office that is responsible for coordinating the enrollee's FEHB coverage.

    Address Line 1

    System generated

    Displays the first line of the domestic or foreign street, PO box, rural route, etc., of the employing, personnel, or point of contact office that is responsible for coordinating the enrollee's FEHB coverage.

    Address Line 2

    System generated

    Displays the second line of the domestic or foreign street, P O Box, rural route, etc., of the employing, personnel, or point of contact office that is responsible for coordinating the enrollee's FEHB coverage.

    Address Line 3

    System generated

    Displays the third line of the domestic or foreign street, PO box, rural route, etc., of the employing, personnel, or point of contact office that is responsible for coordinating the enrollee's FEHB coverage.

    City

    System generated

    Displays the name of the domestic or foreign city for the enrollee's employing, personnel, or point of contact office.

    Note: If the address is an overseas military address, this field displays FPO for fleet post office or APO for army post office in lieu of the city.

    State

    System generated

    Displays the State, U.S. territory, or overseas military abbreviation for the enrollee's employing, personnel or point of contact office. For a list and descriptions of State, U.S. territory, and overseas military abbreviations, see State, U.S. Territory, and Overseas Military Abbreviations Table.

    Zip

    System generated

    Displays the ZIP Code or foreign postal code for the enrollee's employing, personnel, point of contact office.

    Country

    System generated

    Displays the country code for the enrollee's employing, personnel, or point of contact office.

    Agency ID

    System generated

    Displays the Agency identification code for the enrollee's employing, personnel, or point of contact office (example: AG90 for U.S. Department of Agriculture, Office of the Chief Financial Officer).

    Personnel Office ID

    System generated

    Displays the personnel office number for the enrollee's employing, personnel, or point of contact office.

    Authorized Official Last Name

    System generated

    Displays the the last name of the Agency official who is authorized to sign the Form 2809.

    Authorized Official First Name

    System generated

    Displays the first name of the Agency official who is authorized to sign the Form 2809.

    Authorized Official Initial

    System generated

    Displays the middle initial of the Agency official who is authorized to sign the Form 2809.

    Contact (Personnel) Last Name

    System generated

    Displays the last name of the personnel office contact.

    Contact (Personnel) First Name

    System generated

    Displays the first name of the personnel office contact.

    Contact (Personnel) Initial

    System generated

    Displays the middle initial of the personnel office contact.

    Contact (Personnel) Phone

    System generated

    Displays the personnel office contact's daytime area code and telephone number.

    Contact (Payroll) Last Name

    System generated

    Displays the last name of the payroll office contact.

    Contact (Payroll) First Name

    System generated

    Displays the first name of the payroll office contact.

    Contact (Payroll) Initial

    System generated

    Displays the middle initial of the payroll office contact.

    Contact (Payroll) Phone

    System generated

    Displays the payroll office contact's daytime area code and telephone number.

    Effective Date

    System generated

    Displays the date (MMDDYY) the requested action goes into effect.

    Date Received

    System generated

    Displays the date (MMDDYYYY) the Agency received the original 2809 form.

    Report #

    System generated

    Displays the number of the original report (e.g., notification to carrier, transmittal number, etc.).

    Remarks

    System generated

    Displays the remarks about this record.

    Note: To view another record, click your browser's Back button to return to the Form 2809 Search Results page and click View next to the applicable record.

See Also

Maintaining 2809 Records

Adding a 2809 Record

Updating a 2809 Record

Releasing a 2809 Record

Canceling a 2809 Record