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Health and Life Insurance Forms
Health Care Forms
If you were hired prior to October 1, 1987, you participate in the Federal health care program. The following form should be used to enroll in the Federal Plan upon retirement or to make changes in your coverage during Open Enrollment periods or upon a change in family status:
Federal Health Benefits Election Form [PDF]
If you were hired on or after October 1, 1987, you participate in the District health care program. The following form should be used to enroll in the District Plan upon retirement or to make changes in your coverage during Open Enrollment periods or upon a change in family status:
District Health Benefits Registration Form [PDF]
If you have further questions, please contact DCRB Member Services at the number below, or call the Member Services toll-free number at 1(866) 456-3272.
Federal Employees' Group Life Insurance (FEGLI) Program Forms


