United States

Office of

Personnel Management

The Federal Government’s Human Resources Agency

Retirement and Insurance Service

Benefits Administration Letter

 

Number: 99-417 Date: November 10, 1999 

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

Processing Open Season Changes

The purpose of this Letter is to provide agencies with instructions for processing open season

enrollment changes.

I. PROCESSING ROUTINE OPEN SEASON CHANGES

A. Employees who want to continue their current enrollment do not need to take any

action during the open season. However, employees whose plans will not participate

in the FEHB Program after December 31, 1999, or whose plans are dropping a service

area having a separate enrollment code, must enroll in a different plan to continue

FEHB coverage in 1999.

B. Employees who wish to make an open season change and do not have access to

Employee Express (or who choose not to use it) must complete a Standard Form (SF)

2809 (Health Benefits Registration Form) and submit it to the employing office. Open

season SF 2809s generally should be processed in the same manner as registrations

handled at other times; however, agencies should note the following:

1. The event code permitting the change, to be shown in Part D, item 1, of the SF

2809, is 1B; and November 8, 1999, should be entered in Part D, item 2, as

the date of event that permits the change.

2. If there is a change from one plan or option to another, or from self only to self

and family, show the old plan name in Part C, item 1, and the old enrollment

code in Part C, item 2.

3. Complete Part H of the SF 2809. Be sure to enter the date the new enrollment

takes effect in item 3. Enter the SF 2811 report number in item 4. (SF 2811 is

the transmittal form used to send SF 2809s to carriers.) If the report number

for the old carrier is different from that of the new carrier, enter the correct

number on each copy.

____________________________________________________________________________________________

Civil Service Federal Employees Federal Employees Federal Employees

Retirement Group Life Health Benefits Retirement

System Insurance Program System
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4. Enter the correct eight-digit payroll office number (the number of the office that

actually withholds the premiums) in Part H, item 5. (This number can be

obtained from your payroll office.)

5. As a reminder, for temporary employees eligible for coverage under

title 5 United States Code (U.S.C.) 8906a, the following statement should be

included in the "Remarks" section of the SF 2809: "Temporary employee

eligible under 5 U.S.C. 8906a must pay full premium amount with no

Government/agency contribution."

6. For spouse equity enrollees, enter the name and date of birth of the employee

or former employee in the "Remarks" section.

7. For temporary continuation of coverage (TCC) enrollees, in the "Remarks"

section of the new SF 2809, transfer the following information from the

original SF 2809: the enrollment authority, the date TCC eligibility ends, and

the circumstance that permits the TCC enrollment; i.e., separated employee,

former spouse, or child marrying or reaching age 22.

8. Send copy 2 of the SF 2809s to the new carriers to notify them of their new

enrollments. This will enable them to complete the paperwork needed to cover

their new enrollees and issue identification cards.

9. Send copy 3 of the SF 2809s to the old carriers so that they do not guarantee

or provide benefits to employees or family members after enrollments

terminate. (Discard this copy for new enrollments or for enrollment changes

within the same plan.)

It is important that agencies process open season actions promptly, because employees may

have difficulty receiving benefits until carriers have notification of their enrollments.

II. PROCESSING OPEN SEASON CHANGES WHEN THE EMPLOYEE SEPARATES,

TRANSFERS, RETIRES, OR DIES

A. Separation

1. If you know an employee will resign or be separated before the open season

change takes effect, do not accept an open season SF 2809.

2. If you have completed processing the employee's open season change, but the

employee separates before the change takes effect, do the following:

a. Void the open season SF 2809. Send copies of the voided SF 2809 to

both the old and new carriers with an SF 2811.

b. Complete an SF 2810 terminating the enrollment in effect at the time

the employee separates. In the "Remarks" section, write: "Separated

[date]. Open season SF 2809 change dated [date] is void."
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c. Attach a copy of the voided SF 2809 to the carrier's copy of the SF

2809 terminating the enrollment. Send them to the carrier with an SF

2811.

B. Transfer

1. If you know an employee will transfer on or before the effective date of the

open season change, do the following:

a. Have the employee complete an open season SF 2809. Instead of

completing Part H, have the authorized agency official initial and date

Part H to show that the open season registration was submitted timely.

 The name of the losing installation and the signature of its certifying

officer should not appear on the SF 2809.

b. Return the SF 2809 to the employee and tell him or her to give it to the

new employing office to complete processing upon entering on duty.

c. The gaining office will transfer in the old enrollment on SF 2810 before

processing the open season SF 2809.

2. If you have processed the open season change, but the employee transfers on or

before the effective date of the change, do the following:

a. Void the SF 2809. Send a copy of the voided SF 2809 to both the old

and new carriers with an SF 2811.

b. Prepare a memo for the Official Personnel Folder (OPF) stating:

"Transferred [date]. Open season SF 2809 change dated [date] is

void. Accept a new open season SF 2809." 

c. Tell the employee that you voided the change. Then, if possible, have

the employee complete a new SF 2809. Handle the new form as

discussed in paragraph B1 of this section.

d. If it is not possible to obtain a new SF 2809 before the transfer, notify

the gaining agency that the employee's timely filed open season change

has been voided and that the gaining agency should accept a new open

season SF 2809.

C. Retirement

1. If you know an employee will retire before the open season change takes effect,

do the following:

a. Have the employee complete the open season SF 2809. Instead of

completing Part H, have the authorized agency official initial and date

Part H to show that the SF 2809 was submitted timely. The name of
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the installation and the signature of its certifying officer should not

appear on the SF 2809.

b. Attach the SF 2809 to other health benefits documents and the

Individual Retirement Record (SF 2806 under CSRS; SF 3100 under

FERS) when they are submitted to the retirement system. Keep a copy

of this SF 2809 in the employee's OPF as verification.

c. After assuring that the five-year rule has been met, prepare a memo to

the retirement system stating that the open season SF 2809 was

submitted timely and should be accepted for processing. The

retirement system will transfer in the old enrollment on an SF 2810 and

then process the open season SF 2809.

2. If you have processed the employee's open season change, but the employee

retires before the change takes effect, do the following:

a. Void the SF 2809. Send a copy of the voided SF 2809 to both the old

and the new carriers with an SF 2811.

b. After assuring that the five-year rule has been met, prepare a memo to

the retirement system stating: "Employee retired [date]. Open season

SF 2809 dated [date] is void. Accept a new open season SF 2809." 

c. Attach the OPF copy of the memo to other health benefits documents

(including the voided SF 2809) and the Individual Retirement Record

when they are submitted to the retirement system.

d. Send a copy of the voided SF 2809 to the carrier with an SF 2811 at the

same time the application package is forwarded to the retirement

system.

e. Tell the employee that you voided the change. Have the employee

complete a new SF 2809. Handle the new form as discussed in

paragraph C1 of this section.

D. Death

1. If you have processed an open season change, but the employee dies before the

change takes effect, void the SF 2809. Send a copy of the voided SF 2809 to

both the old and new carriers with an SF 2811.

2. If the employee had a self only enrollment, or had a self and family enrollment

and there are no known survivors eligible to continue the enrollment:

a. Complete an SF 2810 terminating the enrollment in effect at the time of death.

 In the "Remarks" section write: "Employee died [date]. Open

season SF 2809 dated [date] is void."
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b. Attach a copy of the voided SF 2809 to the carrier's copy of the SF 2810, and

send them to the carrier with an SF 2811.

3. If the employee had a self and family enrollment and there is at least one

survivor who appears eligible to continue the enrollment:

a. Prepare a memo to the retirement system stating: "Employee died

[date]. Open season SF 2809 dated [date] is void. Accept a new open

season SF 2809 from the survivor if [he or she] wishes to make a

change."

b. Send a copy of the voided SF 2809 to the carrier with an SF 2811 at the

same time the death benefit application and/or other health benefits

documents (including the voided SF 2809) with the Individual

Retirement Record are forwarded to the retirement system.

c. Inform the survivor that you voided the change. Give him or her the

opportunity to make an open season change. Handle the change as

discussed in paragraph C1 of this section. If you are unable to contact

the survivor, attach a notice to the records forwarded to the retirement

system stating that the survivor should be informed of the open season

opportunity.

Please note the following important points to stress when you counsel individuals:

· When transfer, retirement, or death occurs before the effective date of an open season

change, the change must be processed by the new agency or the retirement system.

· There will be a delay in processing the open season change until the new agency or the

retirement system receives the paperwork. The enrollee and the carrier may not have a

record of the enrollment change by the effective date of the change.

· FEHB premiums will be collected by the new agency or the retirement system, effective

on the transfer-in date.

Abby L. Block, Chief

Insurance Policy

 and Information Division