Subject:

Federal Employees' Group Life Insurance Program - Revision of SF 2822, Request for Insurance

What is the revision date?

The revised form is dated January 2002.

Why did OPM revise the form?

We revised the form to:

• Rewrite the instructions in plain language using the question and answer format.

• Update OFEGLI's address.

• Clarify the instructions for agencies.

• Allow agencies to indicate a fax or email address so that OFEGLI can send its approval/denial to the agency by fax or email.

• Eliminate the requirement that the employee sign the form in the presence of agency personnel.

• Add space for the employee's daytime phone number.

• Refine the list of medical questions the employee must answer to align them more closely with the medical questions the insurance company asks in its other group life insurance contracts.

• Add "or other healthcare provider" after "physician" in the several places it appears on the form. Employees do not have to go to a physician for the physical. They can choose to visit any healthcare provider who performs physicals, such as a nurse practitioner.

• Make other minor changes to improve the form.

Because of its low usage, this form is available in electronic format only.

Is this new form available on the Internet?

Yes. You can download the revised form from the FEGLI web site (http://www.opm.gov/insure/life) in a PDF-fillable version.

Can we use previous editions?

No. You should discard all old editions since some information and OFEGLI's address are not current.

Abby L. Block Assistant Director    for Insurance Programs

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