OPM SF 2819 1995-2025 free printable template

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Notice of Conversion Privilege Federal Employees Group Life Insurance Program Federal Employees Group Life InsurancePart A Instructions to Employing Agency Complete Part A of this form whenever an

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How to fill out OPM SF 2819

01

Obtain the OPM SF 2819 form from the official website or your HR department.

02

Fill in your personal information at the top of the form, including your name, Social Security number, and address.

03

Indicate your marital status by checking the appropriate box.

04

List your dependents, including their names, dates of birth, and relationship to you.

05

Provide information about any other benefits you or your dependents may be receiving.

06

Sign and date the form at the bottom.

07

Submit the form to your agency’s human resources office for processing.

Who needs OPM SF 2819?

01

Federal employees who want to apply for benefits under the Federal Employees' Group Life Insurance (FEGLI) program.

02

Survivors or beneficiaries of federal employees seeking benefits.

03

Employees changing their designation of beneficiaries.

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What is OPM SF 2819?

OPM SF 2819 is a form used by the Office of Personnel Management (OPM) to report the designation of beneficiaries for federal employees' health benefits.

Who is required to file OPM SF 2819?

Federal employees who want to designate or update their beneficiaries for health benefits are required to file OPM SF 2819.

How to fill out OPM SF 2819?

To fill out OPM SF 2819, provide personal details such as your name, address, and social security number, as well as the information about your chosen beneficiary, including their relationship to you and their contact details.

What is the purpose of OPM SF 2819?

The purpose of OPM SF 2819 is to provide a formal way for federal employees to designate beneficiaries for their health benefits, ensuring that benefits are distributed according to their wishes.

What information must be reported on OPM SF 2819?

The information that must be reported on OPM SF 2819 includes the employee's personal information, the beneficiary's name, relationship to the employee, and the beneficiary's address and contact information.

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