Federal employees receiving Worker's Compensation payments may use SF 2809 if they wish to change FEHB health plans/options during Open Season. For worker's compensation questions, please call the Department of Labor's toll-free number 1 (866) 487-2365, Monday through Friday from 8 am to 8 pm eastern time.
To make open season enrollment changes send or FAX the completed SF 2809 to the Office of Workers' Compensation Programs at this address below (this cannot be done online):
U.S. Department of Labor
Office of Workers Compensation Programs
P.O. Box 8300 - Region 2
London, Kentucky 40742-8300
Fax (212) 863-0801
Be sure to include your compensation claim number on all requests. The effective date of an Open Season enrollment change is January 5, 2020. The old FEHB carrier is responsible for covering any medical services provided through January 4, 2020. The 2020 FEHB premium will be reflected in their February compensation payment. The FEHB premium for "compensationers" can be calculated by taking the Bi-weekly employee premium times two (x2). For example, Blue Cross Blue Shield Standard Code 104 rate for 2020 is $116.23, which means that the monthly rate to be deducted from your monthly payment would be $232.46.