Health Care Forms
Federal Health Benefits Election Form - If you were hired prior to October 1, 1987, you participate in the Federal health care program. This 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.
Health Coverage Certification for Grandchildren - If you were hired prior to October 1, 1987, you participate in the Federal health care program. This form must be used for annuitants meeting certain criteria to enroll their grandchildren.
District Health Benefits Registration Form - If you were hired on or after October 1, 1987, you participate in the District health care program. This 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 of Columbia Temporary Continuation of Coverage Benefits Enrollment Form - If you participate in the District health care program, you may complete this form to enroll in the District's Temporary Continuation of Coverage (TCC) within certain periods of a qualifying event or receiving notice of eligibility.
Life Insurance Forms
| Form # | Form Name | Where to Mail the Form |
| SF 2823 | Designation of Beneficiary Form | Office of Personnel Management Retirement Operations Center P.O. Box 45 Boyers, PA 16017 - 0045 |
| SF 2817 |
Life Insurance Election |
Member Services Center District of Columbia Retirement Board 900 7th Street, NW, 2nd Floor Washington, DC 20001 Email: [email protected] Fax: 202-566-5001 |
If you have further questions, please contact DCRB Member Services at the number below, or call the Member Services toll-free number at (866) 456-3272.