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Get Fehb Premium Conversion Waiver

Attachment 3 Federal Employees Health Benefits Program FEHB Premium Conversion Waiver/Election Form Purpose of This Form This form is used to elect or waive pre-tax treatment of employee premium contributions to the FEHB Program. Pre-tax treatment is automatic. You do not need to complete this form unless you elect not to have your FEHB premium contributions deducted on a pre-tax basis or you previously waived this benefit and now elect to partic.

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