What is the revision date?

The revised form is dated June 2000.

What is new on this form?

We revised the form to reflect the current policy on electing Option C multiples. We changed Event #2 (life event) on the SF 2817 for Option C - Family in the Table of Effective Dates on the Back of Part 2. This event now reflects the current policy - employees can elect 1-5 multiples of Option C for each life event (up to a total of 5 multiples). It does not matter how many family members they have or acquire with the event.

This policy is not new. We announced it in Benefits Administration Letter number 99-212, dated July 30, 1999. However, this is the first time that the SF 2817 reflects that policy.

We also corrected an error in Part 2, item 5 of the form. The April 1999 form instructs agencies to enter 998 in the Insurance Code box if the employee waives all insurance. That is wrong. Agencies should enter 4 zeroes in the Insurance Code box if the employee waives all insurance.

Finally, we added a space for the employee's daytime phone number and made a few other minor changes.

How do we order the form?

You can order the revised form from GSA/FSS (General Services Administration, Federal Supply Service) using normal FEDSTRIP/MILSTRIP procedures (special procedures specified in your agency's procurement or acquisition office for obtaining items from GSA). You may also order the form from a GSA Customer Supply Center using your government credit card.

Is this new form available on the Internet?

Yes, it's been available on our web site since June 28, 2000. You can download the revised form from the FEGLI web site (http://www.opm.gov/insure/life) in PDF-fillable and Forms Flow versions.

Can we use previous editions?

You may use the April 1999 version, but cannot use versions earlier than that. However, we strongly recommend that you use the June 2000 version, because the April 1999 version contains errors.

What is the form's stock number and cost?

The National Stock Number (NSN) for the SF-2817 is 7540-01-231-4280. The cost is $8.75 per hundred.

Abby L. Block Assistant Director     for Insurance Programs

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