Health Benefits Election Form
Health Benefits Election Form Form Approved: OMB No. 3206-0160 Standard Form 2809 Previous edition is not usable ... Office toll-free at 1-888-767-6738. 3. Former spouses eligible to enroll in or currently enrolled in the FEHB Program under the Spouse Equity law or similar statutes. 4. Individuals eligible for Temporary Continuation of Coverage ... ................
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