OPM Forms
Use these e-signature forms to complete common transactions.
Upon completion with required attachments and signing of the form (and signature from OPM where applicable), the form will automatically route to OPM and you will receive a copy in your email for your records.
Upon completion with required attachments and signing of the form (and signature from OPM where applicable), the form will automatically route to OPM and you will receive a copy in your email for your records.
Request to cancel or suspend health insurance (form RI 79-9)
Use this form to cancel or suspend your health insurance coverage under the Federal Employees Health Benefits (FEHB) program due to:
- Becoming covered under a family member’s FEHB plan (item A),
- Enrollment in a Medicare Advantage health plan (item C),
- Coverage under TRICARE, TRICARE for Life, Peace Corps, or CHAMPVA (item D), or
- Coverage under Medicaid or similar state-sponsored program of medical assistance for the needy (item E).
Supporting documentation is required, unless you cancel your coverage under item B (which means you cannot later reenroll in FEHB).
If you are enrolled in a Postal Service Health Benefits (PSHB) plan, go to the
to submit a health benefits change.
Notice of change in marital status (previously form RI 20-120)
Use this form to notify OPM that:
- Your spouse has died,
- Your marriage ended due to divorce, or
- Your marriage was annulled.
Documentation supporting your change in marital status is required.
Health benefits change outside of open season (form OPM 2809)
Use this form to submit a Federal Employees Health Benefits (FEHB) change due to:
- A such as a change in family status (e.g., marriage, birth or death of a family member, adoption, or divorce), or
- To decrease health insurance coverage (e.g., from a Self and Family plan to Self Plus One or Self Only plan).
Supporting documentation is required for a QLE change. Do not use this online form to submit an Open Season election.
If you are enrolled in a Postal Service Health Benefits (PSHB) plan, go to the
to submit a health benefits change.
Foster child certification
If you are adding a foster child to your health insurance plan, then you must submit:
- A certification of foster child status,
- A copy of the child’s birth certificate, and
- Documentation showing the parent-child relationship and evidence of regular and substantial financial support.
A grandchild must qualify as a foster child to be considered an eligible family member.
Direct premium payment or plan change election
If your annuity is insufficient to cover the monthly premiums for your health insurance coverage, then you will need to submit your election to:
- Pay premiums directly for your health insurance, or
- Change to a less expensive plan.
If you elect to pay your premiums directly to the National Finance Center (NFC), you will receive coupons and instructions from the NFC for making your premium payment on the first of each month.