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District of Columbia Retirement Board
 

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Open Enrollment period for the Federal Employees’ Health Benefits (FEHB) and the District Employees’ Health Benefits (DCEHB) programs is just around the corner.
Open Enrollment for 2023 begins on Monday, November 14, 2022, and ends on Monday, December 12, 2022. Details will be available November 14.

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Federal Health Benefits Election Form


Friday, October 22, 2021

Use this form to:

  • Enroll or reenroll in the FEHB Program; or
  • Elect not to enroll in the FEHB Program (employees only);or
  • Change your FEHB enrollment; or
  • Cancel your FEHB enrollment; or
  • Suspend your FEHB enrollment (annuitants or former spouses only).

Complete, print, sign, and return the last two pages of the following form to the DCRB Member Services Center.

You can send the completed forms and any required attachments by fax to (202) 566 -5001 or by mailing your documents to:

DC Retirement Board
Member Services Center
900 7th Street, NW, Second Floor
Washington, DC 20001

If you have further questions, please contact the DCRB Member Services Center by clicking on the Ask Member Services link, or by phone at (202) 343-3272 Monday – Friday from 8:30 am to 5:00 pm.