Get Washington

This guide provides clear instructions for completing the WASHINGTON form online. Users should carefully follow each step to ensure their enrollment requests are processed correctly.

Follow the steps to fill out the WASHINGTON form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Identify which cancellation or suspension option applies to you by referring to the labeled sections A through E on the form.
3. If canceling your FEHBP enrollment under section A, provide your spouse's name and claim number, and attach the relevant SF 2809 form if applicable.
4. If canceling for reasons in section B, read the implications carefully and ensure you are aware that you will not be eligible to reenroll in FEHBP.
5. For section C, include documentation of your Medicare Advantage health plan enrollment if you are suspending your FEHBP enrollment.
6. In case of suspending enrollment for TRICARE or other programs in section D, provide evidence of eligibility like a Uniformed Services ID card and Medicare card if applicable.
7. For section E, prepare evidence of your Medicaid or state-sponsored medical assistance program coverage, like an enrollment card.
8. Sign and date the form after reviewing all provided information, affirming your understanding of the implications of your choices.
9. Submit the completed form by returning it to the Office of Personnel Management (OPM) by the appropriate means.
10. After submission, be sure to check for any notifications regarding the processing of your request, and save a copy for your records.

Complete your documents online today to ensure your health benefits are managed effectively.