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This pamphlet c

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the monthly pre

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For more inform

www.opm
General Inform

Requirem

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Time Lim

Employees’ G

Insurance 

Insurance 

Individu

The Cost 

Basic Life 

Option A 

Option B 

OptionC

How to C

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Terminatio

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Option A - St

How Your 

Who Receives 

Reem

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Additional In

How to D

Life Insu

Option C - F

How to Fi

Family Ins

Living Benefits 

Irrevocable Ass

Information fo
discuss your o

program in ge

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trained to pro

in a wide vari

of the services 

mailing and p

To reach the R

1-888-767-67

holidays and w

7:30 a.m. to 7

Friday. Annuit

have TDD eq

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a secure, pin-

convenience t

annuity paym

and direct dep

and State inco

describing you

To authorize c

you will need 

instructions so 

life insurance 

intentions doc

Whether you 

sure to give us 

number (CSA 

corresponden

your full name 

Security numb
your life insur

assigned your 

the ability to c

coverage or d

personal right

Life Insurance 

If you become 

make any cha

this area is de

life insurance 

regain compe

favor of anoth

personal right

court-appoint

assigned your 

assignee (the 

Address your 

U.S. Offic

Retireme

P.O. Box 

Boyers, P

Note to empl

This pamphle

the U.S. Offic

have access to 

employees ne

resources offic

information a
The Federal E

Program prov

value; it is inte

your death. Yo

life insurance 

Requiremen

Coverage in

Your Basic Life

Additional, an

coverages (de

have) are con

1.	 you retire

began wi

2.	 you were 

immediat

date or fo

coverages 

3.	 you elect

4.	 you did n

individua

Note that und

System, an im

an annuity if y

age and have 

requirements 

insurance cov

postpone rece

postpone rece

until the date 

continue the c

it will resume 

even if you co

individual pol
31-day tempo

extension of y

accidental dea

automatic. If y

to) continue li

had the oppo

Generally, to h

you had to ap

first premium 

31-day tempo

Time Limit o

Policy 

To convert to 

applied by fol

Form 2819, N

31 days after y

or within 31 d

whichever gav

insurance afte

within 31 day

RI 76-1, You C

Insurance, or 

Your Optional 

Personnel Ma

extension of c

had Federal li

For conversio

Office of 

Life I

P.O. Box 

Long Islan

For overnight 

conversion re
If you were un

within the 31-

control or you 

make a belate

You must mai

after you first 

individual pol

explanation o

prevented you 

Office of Fede

will determine 

Regardless of 

coverage begi

coverage term

conversion pr

The Cost of 

You can deter

from the discu

annuity paym

premiums fro

the premiums 

to cover the c

your monthly 

the life insura

opportunity to 

to make direc

payments as l

enrollment in 

annuity increa

your life insur

direct pay opt

Retirement Sy

low to cover t

October 30, 1
adjusted as ne

Basic Life In

The amount o

known as “Reg

(1) your annu

separated for 

pay in effect a

non-pay statu

Generally, the 

thousand) is ro

plus $2,000 to 

or face value, 

example, if yo

your Basic life 

$30,000. Also

of your Basic 

multiplication 

benefit is not 

life insurance. 

Note: Acciden

insurance stop

Items 1, 2, an

cost of Basic l

which your co

65. 

1.	 If you sep

Decembe

begin to r

month be

the date y

you retire

continues 

25% of th

For exam

birthday o

insurance 
2. If you sep

Decembe

you elect

schedules 

� 75% 

redu

will b

each 

mon

seco

later

Basic 

value

9, 19

� 50% 

redu

will b

each 

mon

seco

later

Basic 

value

cove

from 

and 

prem

the f

in eff

not r

amo

retire

� No R

sche

insur

age 6

addit

begin

life. T

mon

the B

retire
insurance 

monthly 

the Basic 

This prem

required 

Reductio

example 

monthly 

will conti

Reductio

annuity th

Example: 

for retirem

you: 

1.	 have 

value 

2. elect 

your mon

insurance 

and the m

Reductio

withhold 

your Basi

the end o

However

based on 

Reductio

your ann

cancel yo

If you elected 

that election a

your insuranc

life insurance 

amount of yo

you had elect

Note that you 

Reduction to 

election, you 

premiums we 

cancellation w
withholding fo

The following 

insurance and 

who retired af

Election 

75% 

Reduction 

50% 

Reduction 

No 

Reduction 

These rates a

Option A - S

The amount o

(formerly know

at retirement. 

your Option A 

$10,000. If yo

reduce by 2% 

second month 

after you retir

25% of the fac

premiums for 

through the e

unless you ele

cancel your in

cost of Option 

The premium

group until yo

table: 
Age 50 throug

Age 55 throug

Age 60 throug

Age 65 and O

These rates a

When you go 

premiums wil

after your birt

reflected in th

are 60 in May

insurance wou

effective June 

reflected in yo

your annuity a

of June. 

We will stop w

your annuity t

For example, 

for Option A i

shown in you

annuity and in

June. 

Option B - A

Option B - Ad

active Federal 

was not availa

April 1981. Th

multiplying yo

to the next hig

B multiples th

service immed

entire periods 

were available 

‘multiple’ equ

rounding up t

have as many 
If you separat

April 24, 1999

B insurance in 

elect how ma

continue in re

your multiples 

gradually redu

We will give a

an election re

second oppor

are 65 or olde

we are proces

will contact an

shortly before 

annuitant may 

Reduction for 

For example, 

No Reduction 

remaining mu

If you elect Fu

month after y

second month 

your Option B 

by 2% of the f

which time th

premiums for 

the month in 

If you elect to 

multiples with 

at retirement, 

withholding fo

number of mu

reduction. An

described abo
Age 

Grou

Under age 35 

Age 35 throug

Age 40 throug

Age 45 throug

Age 50 throug

Age 55 throug

Age 60 throug

Age 65 throug

Age 70 throug

Age 75 throug

Age 80 and o

* For multiples t

No cost for mu

These rates a

When you go 

premiums wil

after your birt

reflected in th

are 60 in May 

insurance was 

premium for t

(84 x $.607) t

June 1. 

This increased 

payment date

insurance pre
June 1. This w

1, covering yo

the month of 

OptionC-F

OptionC-Fa

to active Fede

coverage was 

before April 1

before April 2

the amount o

a spouse and 

child. 

The life insura

through June 

for most empl

Option C insu

$5,000 covera

eligible depen

event,” such a

that occurred 

eligible to inc

The effective 

that included 

period also pe

life event to e

This increased 

effective on A

was in a pay a

election oppo

The amount o

number of Op

for the five ye

retirement, or 

which this cov

five years. 
Eligible childre

1.	 your unm

than a sti

children, 

2.	 your unm

foster chi

parent-ch

3.	 your unm

out of we

a regular 

receiving 

you. 

To be covered

or over, incap

or physical dis

became 22 ye

age 22 or ove

a claim for be

whether a fost

call our Retire

If you separat

were eligible t

retirement, yo

age 65 — som

continue at th

zero. We will 

retirement an

If you elect Fu

separated for 

effective the f

reach age 65 

after you retir

full-reduction 

value per mon

coverage will 

this coverage 

in which you 
number of mu

The cost of O

the number o

you elect, as s

Ag

Under age 35 

Age 35 throug

Age 40 throug

Age 45 throug

Age 50 throug

Age 55 throug

Age 60 throug

Age 65 throug

Age 70 throug

Age 75 throug

Age 80 and o

* For multiples t

No cost for the 

These rates a

When you go 

premiums wil

after your birt

reflected in th

are 60 in May

insurance wou

effective June 

reflected in yo

your annuity a

of June. 
payment date

and insurance 

You are the be

After your dea

surviving fami

convert to a n

How to Cha

after Retirem

Unless you ha

cancel it at an

insurance, you 

insurance as w

If you elected 

insurance, you 

any time. If yo

you may canc

cancel) the am

OptionC-Fa

please write to 

If you have as

elected a livin

any change yo

Assignment an

may prevent y

Write to: 

U.S. Offic

Retireme

P.O. Box 

Boyers, P

Be sure to giv

number (CSA 

want taken. G

effective at th

your written r
(y

remember tha

the first busine

insurance pre

Termination 

Your Federal l

entitlement to 

you are a disa

found recover

disability annu

You do not ha

and may not c

individual pol

If you are a di

terminated as 

life insurance 

apply for an im

You will receiv

your right to d

terminates. Al

disability annu

capacity or a 

you retired, yo

your life insur

coverage of th

in effect at the 

terminated ca

to a deferred 

terminates, yo

coverage as a 

individual pol

annuity and li

you are reemp

explained in t
P.O. Box 

Boyers, P

You should se

document sho

(2) the full nam

agency and th

should also as

OPM Form 14

Reemployed A

If Annuity Ter

If you are reem

terminate you

as a retiree als

an individual 

insurance cov

are reemploye

coverage. 

If Annuity Co

If your annuity 

and you are re

excluded from 

any Basic and 

have as a retir

Basic Life, Op

If you are reem

coverage, you

and Option C 

transferred to 

page 19 for in

eligible for thi

employee, yo

withhold the a

We will suspe

Option C cov

your reemploy
more informa

You are eligib

unless you ha

insurance or O

can acquire O

employee, un

Basic life insu

Option B ­

If you are reem

coverage, you 

Additional ins

waiver of Basi

However, if yo

coverage will 

Option B insu

Insurance Elec

31 days after y

employing age

employee-acq

salary. (Please 

employing age

reconfirm all t

Option B. Oth

cancelled.) In 

as a retiree (in

your annuity) 

reemploymen

from your em

After Your Re

You may retai

insurance (exc

ment benefits

1.	 you comp

full-time 

equivalen
if less tha

Basic Life, Op

If you are elig

you meet the 

reemploymen

choose to con

ment-acquire

of your suspen

Option B ­

� If you dec

insurance 

no effect 

� If you file

Insurance 

electing O

suppleme

listed abo

life insura

Option B 

reemploy

from you

notificatio

If your annuity 

but you are no

ment-acquired 

life insurance 

reinstated cov

have had if th

i.e., your cove

or older. We w

your annuity, 

notification fro
When you die

Federal Emplo

pay life insura

1. If you ass

OFEGLI w

� First, 

your 

� Seco

your 

2.	 If you did 

valid cou

accordan

3.	 If you did 

valid cou

� To th

� If yo

bene

you a

desig

or w

� If no

child

child 

that 

� If no

equa

survi

� If no

exec

* A valid court 

property settle

of divorce, an

or the U.S. Of

after July 22, 

valid if you fil

you retire. Su

Federal Emplo
assigned your 

is not on file, 

However, if yo

payment listed 

any designatio

If there is a va

change or sub

the person(s) 

writing or unle

voided. 

You cannot de

assigned your 

designate ben

If item 3 appl

than one bene

who dies befo

the surviving b

If none of the 

reverts to the 

If item 3 appl

of beneficiary 

Group Life Ins

benefits, OFEG

next most rec

If there is no d

will follow the 

Standard Form 

gives detailed 

form and wha

law and regul

* See footnote on 
you submit an

correct inform

before you do

insurance ben

Remember th

designation, t

spouse — wil

death. 

If your life ins

Termination o

designation of 

void 31 days a

reacquire insu

new form with 

your new insu

beneficiary. 

If any person 

make a claim 

payment to su

statute or regu

order shown i

person had di

your death, no 

entitled to pay

may be made 

the Office of P

entitled to the 

no one else ca

Claims should 

Office of 

Group 

P.O. Box 

Utica, NY 
y

starting on pa

beneficiary. D

power of atto

incompetent, 

be altered. 

You may obta

of Beneficiary, 

cancel a previ

number, from 

to our Pennsy

may downloa

www.opm.gov

After you com

to this same a

must be in wr

and received 

before your d

your intent do

beneficiary. W

named as ben

Be sure 

benefic

make p

benefic

If you name m

specify their r

benefits, othe

percentages o

amounts. 
How Your S

Benefits 

Your beneficia

on page 21 sh

your death. 

The beneficia

full name and 

number (CSA 

(2) date of bir

The Office of 

time will furni

for Death Ben

benefits. The 

Office of Fede

not with OPM

the responsibi

are payable to 

death and any 

at that time. 

Wh

Und

F

If you have O

beneficiary. N

law. If you sho

family membe

payment will 

whom your B
load the form 

provides com

through OPM

the benefit be

eligible family 

If we are with

your annuity a

family membe

withholding p

In the event o

member can c

individual pol

within 31 day

the right to co

You may elect 

a living benefi

documented 

expected to li

annuitants ma

to their Basic 

benefit for pe

be in effect ni

Federal Emplo

receives a com

life insurance 

reduced amou

receives the c

elect a partial 

available only 
Your living be

nominal amou

Life Insurance 

benefits. 

If you receive 

Basic life insu

We will stop w

premiums fro

living benefits 

Basic life insu

premiums we 

upon the amo

before retirem

Your election 

amount of any 

We will contin

optional insur

You may cont

Group Life Ins

Form FE-8, Cl

benefits. This 

from your reti

Irrevoca

If you wish, yo

or more perso

you agree to g

A and Option 

cannot cance

the beneficiar

continue to pa
Only you can 

can do it on y

to make an as

insurance to c

order for divo

purposes, or t

a)	 To compl

your life i

court ord

order a F

as the life 

insurance 

means fo

insurance 

spouse or 

b)	 For inher

assignme

an individ

a gift to th

estate of 

law allow

that porti

surviving 

immediat

of a life in

since stat

Federal o

insurance 

taxes, it is 

competen

The Offic

no respon

the validi

an assign

A determ

proceeds 

ultimately 

Service at 
d)	 To satisfy 

insurance 

a debt. 

By assigning y

to designate b

of insurance c

you can afford

If you assign y

person, you m

for each perso

contingent ass

predeceases y

An assignmen

you have mad

assignee(s) ma

may designate 

as the benefic

the assignee o

contingent be

designation of 

is responsible 

current addre

beneficiary, th

receives the b

An assignee m

insurance cov

The assignee a

insurance. If t

of them must 

coverage. 

The assignee h

rights as those 

this booklet, a

on or before t
to us or down 

Assignment of 

Insurance, at w

assignment w

the properly c

assignment fo

assignment ar

C

If your life ins

terminated an

the Departme

Compensation 

allow you to c

compensation

conditions as 

coverage as a

November 2, 

completion of 

of your life ins

age 65, as lon

and are deter

be unable to r

If the Departm

capable of ret

or if they cont

payments, or 

work), contac

human resour

at the Office o

(OWCP) to le

is affected. Als

www.opm.gov
because you a

and you are n

work, you can 

elect retireme

situation and 

pay you. Then 

start payment

to the Depart

waive Worker

from us. If you 

will continue, 

from your mo

The informati

service, startin

Compensation

retirement.

We hope this 

other question

benefits, you 

write to us at 

U.S. Offic

Retireme

P.O. Box 

Boyers, P

If you do write

service retirem

date of birth t

promptly.

Our Internet a

Address emai
pp

their respectiv

more of these 

the address sh

Information fo

Civil Service R

Information fo

on the Federa

Retirement Sy

Information fo

Survivor Annu

Federal Emplo

Program