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Annuitant/OWCP Health Benefits Election Form
This form is used by annuitants of Federal retirement systems other than the Civil Service Retirement System (CSRS) and the Federal Employees Retirement System (FERS), including the Foreign Service Retirement System and the Office Worker's Compensation Programs and certain former dependents of these individuals.
Form #:  SF 2809-1
Agency:  Office of Personnel Management
  TYPE PAGES SIZE (KB) CAPABILITY WHAT'S
NEEDED
pdf Both Form and Instructions 14   [3] Fillable + Printable Adobe Reader Download  

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