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U.S. Office of Personnel Management
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Ensuring the Federal Government has an effective civilian workforce
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Insurance Services Programs
Federal Employees Health Benefits Program
FEHB Carrier Application for Download
If you want to apply to participate in the FEHB Program, please do the following:
Download each of the Microsoft Word files below;
Complete the application and certifications as directed;
Send the completed application to OPM by January 31; and
Complete the information form on the next screen. We will then be able to contact you with any significant updates to the materials you downloaded.
Cover Letter
[31 KB]
Application for FEHB
[80 KB]
Anti-Lobbying Certification and Disclosure
[34 KB]
Drug Free Workplace Certification
[27 KB]
FEHB Fact-Sheet
[15 KB]
Sample Contract
[414 KB]