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Sf 2809 health Form: What You Should Know
Use this form to: • Switch designated eligible family Use the Health Benefits Election Form to switch to an employer health plan. If you have been offered a new health plan as a result of an offer or termination of your contract of employment, and you were enrolled in Part A, Part B, or Medicare Advantage within the last 24 months then you may continue to use this version of the form to file an “election” for the new employer plan. To change your enrollment in Part A, Part B, or Medicare Advantage within the last 24 months go to Forms. Employee Benefits Handbook. Use the Health Benefits Election Form to file your “election” for the new health plan. NOTE: DO NOT USE THESE FOR THE PURPOSE OF DETERMINING WHETHER THIS OR ANY OTHER EMAIL AND/OR WRITTEN FORM IS ADVERBIAL OR ADVERBIAL Election Form for Medicare Part B (Part D) and Medicare Advantage D (Part C) (Form SF-2807) Election for Medicare Part B (Part D). Current Revision Date: 11/2018. Authority or Regulation: Chapter 89, Title 5, U.S.C. & Medicare Form SF-2807. Medicare Part B: Part D Election. Federal Employees Health Benefits Program. To receive this form you must log in using your federal employer identification (FEB) number and access “My FEB” using your FEB access code. To learn how to access your FEB account go to.
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