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Get OPM SF 2809 2011

is on your Medicare Card. • Enroll or reenroll in the FEHB Program; or Item 9. • Elect not to enroll in the FEHB Program (employees only); or If you are covered by other health insurance, either in your name or under a family member’s policy, check yes and complete item 10. • Change your FEHB enrollment; or • Cancel your FEHB enrollment; or • Suspend your FEHB enrollment (annuitants or former spouses only). Item 10. Provide the information requested on any other .

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