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ATTACHMENT 2 FEB PROGRAM TABLE 1 PLANS LEAVING THE FEB PROGRAM Enrolled in the terminating plans who do not change their health plan by enrolling in another FEB plan during Open Season will not have
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How to fill out attachment 2 - fehb
How to fill out attachment 2 - FEHB:
01
Start by downloading attachment 2 - FEHB from the official source.
02
Open the form using a PDF reader or any compatible software.
03
Begin by providing your personal information, including your full name, address, and contact details.
04
Indicate whether you are a federal employee or an eligible family member.
05
If you are a federal employee, provide your agency name, department, and position.
06
Fill in the appropriate sections if you are an eligible family member and indicate the federal employee you are related to.
07
Declare whether you are electing self-only coverage or family coverage.
08
If you are electing family coverage, provide the names of your eligible family members who will be covered under the plan.
09
Choose your preferred plan option from the available options provided.
10
Indicate whether you want to enroll in a dental plan and/or vision plan, if applicable.
11
If you have any other insurance coverage, indicate the type of coverage and provide the policy number.
12
Review all the information you have entered to ensure accuracy and completeness.
13
Sign and date the form at the designated area.
14
Submit the completed attachment 2 - FEHB form to the appropriate entity as instructed.
Who needs attachment 2 - FEHB?
01
Federal employees who are eligible for the Federal Employee Health Benefits (FEHB) program need attachment 2 - FEHB.
02
Eligible family members of federal employees who will be covered under the FEHB program require attachment 2 - FEHB.
03
Anyone who wishes to enroll in a health plan provided by the FEHB program, whether as a federal employee or as an eligible family member, will need attachment 2 - FEHB to indicate their choices and provide the necessary information.
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