RI 76-10
April 2000
WARNING! This form permanently transfers ownership of your FEGLI insurance to another individual, trustee, or corporation (however, premiums continue to be withheld from your salary/annuity). An assignment is irrevocable, and cannot be changed later. DO NOT USE THIS FORM if you only wish to designate a beneficiary to receive your life insurance. Instead, use the designation of beneficiary form available here.
For more information about assignments and designations of beneficiary, see the FAQs FEGLI Handbook Chapters on Assignments, and Designation of Beneficiary and Order of Precedence.
Use:
FEGLI enrollees use this form to assign ownership of their life insurance coverage to another person, firm, or trust; and assignees use the form to reassign the coverage.
Electronic Copies:
PDF Fillable Version
Paper Copies:
Employees:
Request a paper copy of this form from your servicing Human Resources Office.
Annuitants or Assignees:
- Call toll free 1-888-767-6738 (202-606-0500 in the DC Area), or
- Send an email to retire@opm.gov, giving the number of the form that you need and your mailing address, or
- Request a copy from a local Federal agency Human Resources Office.
Agencies:
Once a year, OPM sends out a Benefits Administration Letter offering agencies the opportunity to "ride" OPM's requisition for RI forms and publications. This is a time-limited offer. You must submit your orders through your agency headquarters. There is no other way to get printed copies of the RI forms. If you miss the opportunity, you have to wait until the next year.