United States 

Office of 

Personnel Management 

The Federal Government’s Human Resources Agency

Benefits Administration Letter 

Number: 05-406 Date: October 28, 2005 

Subject: 2005 Federal Employees Health Benefits (FEHB) Program Open Season: Ordering 

and Distribution of Material

OVERVIEW 

Open Season Materials

We have attached a list of carrier contacts for ordering health plan brochures (Attachment 1) and 

contact information, including street addresses, for submitting enrollment forms (Attachment 2) 

to Carriers for the 2005 FEHB Open Season. The list includes health maintenance organization 

(HMO) plans; plans offering a point of service (POS) product (other than managed fee-forservice plans) and; consumer-driven health plans (CDHP) and high deductible health plans 

(HDHP). 

The following materials will be available during the 2005 Open Season: 

Plan brochures. The health plan brochures are the statements of benefits, exclusions, and 

limitations. 

For the visually impaired, audio cassettes of the open for-fee-service plan brochures are 

available. This year, all of the plan brochures are on the FEHB website. The brochures are 

available in Adobe Acrobat 7.0 PDF format and are compliant with Section 508 requirements for 

materials for the visually impaired. 

SF 2809 (Health Benefits Election Form) - The following individuals may use the SF 2809 if 

they are eligible to enroll in or are currently enrolled in the FEHB Program: 

 Employees, including temporary employees eligible under 5 U.S.C. 8906a. 

 Annuitants (other than Civil Service Retirement System (CSRS) and Federal Employees 

Retirement System (FERS) annuitants), including individuals receiving monthly 

compensation from the Office of Workers’ Compensation Programs (OWCP). 

 Former spouses eligible under the Spouse Equity provisions of FEHB law or similar 

statutes. 

 Individuals eligible for temporary continuation of coverage (TCC), including: 

o Former employees (who separated from service); 

o Children who lose FEHB coverage; and 
o Former spouses who are not eligible under the Spouse Equity provisions of FEHB 

law. 

Ordering Information 

The SF 2809 can be ordered from the General Services Administration’s (GSA) Federal Supply 

Service using the normal FEDSTRIP/MILSTRIP procedures. Ordering information is provided 

below: 

Form Number Title of Form National Stock No. Estimated Cost 

SF 2809 Health Benefits Election Form 7540-01-231-6227 $28.62 per 100 

The SF 2809 can also be accessed from our website at: http://www.opm.gov/insure/health. 

If your employees have access to Employee Express or another electronic FEHB enrollment 

system, please keep this in mind when deciding how many forms to order. SEE BAL 04-405 for 

additional information on the SF2809. 

FEHB Guides - These publications are available on our website at 

http://www.opm.gov/insure/health. The FEHB Guides provide summary information on the 

health plans participating in the FEHB Program, with information on the plans available in each 

State, rates, benefits, accreditation, and quality indicators. They also provide information on 

program features and enrollment instructions. Since they can be downloaded and printed as 

needed, this may be a better alternative if you need small quantities. The actual cost of items 

will vary, depending upon the various specifications and quantity. However, the most 

economical way of obtaining bulk quantities is to ride the OPM printing requisition(s). SEE 

BAL 05-403 for additional information. 

 

PLAN BROCHURES

All Plan brochures are available for downloading from the FEHB website: 

http://www.opm.gov/insure/health. Please encourage your employees to use the website as their 

primary resource. The brochure PDFs are in Adobe Acrobat 7.0 version. 

Shipping and Packing

The plan brochures will be packaged in groups of 25 and boxed at up to 250 items per container. 

How Do We Get Fee-for-Service Plan Brochures?

Fee-for-service plans will ship a supply of their brochures to each of your designated distribution 

points. In addition, all plan brochures will be on the 2005 FEHB Open Season website at: 

http://www.opm.gov/insure/health. Fee-for-service plans will get a distribution list that shows 

the quantity they are to ship to each distribution point (generally 15% of the eligible FEHB 

population). 

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How Do We Get Health Maintenance Organization (HMO), Consumer Driven and High 

Deductible Health Plan Brochures?

You must order these brochures directly from the plans (see attached list). The personnel official 

designated for each agency installation must determine the number of employees eligible to 

enroll in each plan, i.e., the number of employees located in the plan's service area. The 

installation must then contact each plan in its area and provide the plan with the following: 

An estimated number of eligible employees. (Be sure to include Spouse Equity and 

Temporary Continuation of Coverage (TCC) enrollees in this estimate). 

The address to which the plan should ship the brochures. 

The plan will compute a quantity equal to 15% of the number of eligible employees and will 

send that number to each agency installation. We encourage you to ask your employees who are 

considering a change, but have not yet decided, to use the electronic versions of the plan 

brochures that are on the FEHB Open Season website at: http://www.opm.gov/insure/health. 

Plan brochures are also accessible to the visually impaired at the same website. 

How Do We Get Brochures for Plans with a Point of Service Product?

Fee-for-service plans with a point of service product will ship a supply of their brochures to each 

of your designated distribution points. 

For HMOs with a point of service product, you must order plan brochures directly from the plans 

as described above. 

What Should We Do With Them? 

Each employee currently enrolled will receive a brochure directly from his/her plan. You must 

keep a supply of brochures on hand for reference and for distribution to employees who decide 

to enroll or change plans. These brochures must be readily accessible to employees. Maintain 

close control over issuing plan brochures. Employees should be allowed to take copies home for 

review. If an employee enrolls or changes health plans, he/she should keep the brochure for that 

plan. The employee should return other brochures to the personnel office. You must give your 

Spouse Equity and TCC enrollees the same access to brochures as employees. Tell your Spouse 

Equity and TCC enrollees how to obtain brochures and SF 2809 enrollment forms if they are 

interested in changing plans. The employing office maintaining the enrollment should tell the 

individual to call the plan at the telephone number listed in the FEHB Guide if they cannot fill a 

request for a brochure, (e.g., if the enrollee lives in an area not served by the plans for which the 

employing office has brochures). 

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MATERIAL FOR THE VISUALLY IMPAIRED

What Is Available?

2006 fee-for-service plan audio cassette tapes for visually impaired employees are available. 

These are tone-indexed cassette tapes of the brochures for the open fee-for-service plans. Each 

plan brochure is available on the FEHB website in Adobe Acrobat 7.0 version PDF and is 

compliant with Section 508 requirements for materials for the visually impaired. To order audio 

cassette tapes for visually impaired employees please use the contact list below: 

OPEN FEE-FOR-SERVICE PLAN CONTACTS 

FOR ORDERING AUDIO CASSETTE TAPES 

Plan Code Plan Name Contact Phone Fax 

47 APWU Ken Perlberg (301)622-5731 (301)622-5712 

10 & 11 BCBS Paula Spurway (202)942-1274 (202)942-1263 

31 GEHA Lisa McDonald (816)257-3334 (816)257-3333 

45 Mail Handlers Gloria Gedrich (301)517-2032 (301)517-2127 

32 NALC Cal Engle (703)729-8101 (703)729-8109 

36 PBP Health Plan Brenda Tanner (703)548-5922 (703)836-8937 

Agency Responsibilities

All Federal agencies at the headquarters and installation levels must take steps to seek out 

visually impaired employees and to let them know that the audio cassette tapes and the FEHB 

website are available. Please encourage your employees to visit the website at: 

http://www.opm.gov/insure/health. 

PREMIUMS

OPM announces premium changes each year in a news release. Agency payroll offices, however, 

must not use these rates to update their payroll systems. OPM's Center for Financial Services 

will issue a Benefits Administration Letter (BAL) giving the official enrollee withholding and 

Government contribution rates and other information relevant to payroll offices. The BAL will 

also provide agencies with information on obtaining a PC-compatible floppy disk containing the 

2006 FEHB rates. 

We encourage you and your employees to visit the website at: 

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http://www.opm.gov/insure/health. The website will be updated regularly with current 

information including any additional plan terminations. 

Sincerely, 

Robert F. Danbeck 

Associate Director 

for Human Resources Products and Services 

Attachment 1

Attachment 2

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