Fegli Insurance Form

Form approved designation of beneficiary omb no.

Fegli insurance form. Use a new form read instructions on the back of part 2 before completing this form. New federal employees in eligible positions are automatically covered by basic insurance and do not need to use this form if they want only the basic coverage. Most employees are eligible for fegli coverage. Option c family life insurance.

Sf2818 continuation of life insurance coverage as an annuitant or compensationer fegli current revision date. Gsa 4003 procurement management review pmr small business compliance review sbcr checklist revised 8 18 2020. Each claimant beneficiary is required to complete their own form. Sf 94 statement of witness renewed 9 2 2020.

Sf2818 12 pdf pdf 1 mb pdf versions of forms. Federal employees group life insurance program fegli designations form. 3206 0136 federal employees federal employees group life insurance fegli program important. Download the form locally or request a downloaded copy from your servicing human resources office.

Name of insured last first middle. Gsa 3703 full time telework arrangement analysis tool revised 9 2 2020. The federal government established the federal employees group life insurance fegli program on august 29 1954. Choose a link below to begin downloading.

The federal employees group life insurance fegli program is a life insurance program for federal and postal employees and annuitants authorized by law chapter 87 of title 5 united states code. Assignees completing this form should read items 5 and 6 on the covered for basic life insurance as an employee. Only use this form for the death of a federal employee annuitant or compensationer. Give all parts of your completed form to your employing office.

When you first become back of part 3. Claim for dismemberment benefits. Claim for death benefits federal employees group life insurance program. Annuitants do not use this form.

Gsa 7501 internal control audit tracking system icats access request revised 8 7 2020. The fegli regulations are in title 5 of the code of. Forms federal employees group life insurance forms. Office of personnel management.

The office of personnel management opm administers the program and sets the premiums. If you are filing a claim for a dependent use form fe 6 dep. Provide all of the information requested so ofegli may process your claim as quickly as possible. Standard form 2823 designation of beneficiary 4 01 where do i send my fegli designation of beneficiary form.