U.S. Office of Personnel Management - Ensuring the Federal Government has an effective civilian workforce

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.

1. Cover Letter [31 KB]
2. Application for FEHB [80 KB]
3. Anti-Lobbying Certification and Disclosure [34 KB]
4. Drug Free Workplace Certification [27 KB]
5. FEHB Fact-Sheet [15 KB]
6. Sample Contract [414 KB]