3
C. Eligibility verification documents approved
Once the employing office has verified family member eligibility, it must make a note in the
Remarks section of the SF 2809 and place the form on the permanent side of the employee’s
Electronic Official Personnel Folder (eOPF) or another comparable personnel file. At a
minimum, the note must indicate the type of document(s) examined, the document’s issue date,
the date of the QLE (if applicable), and the name of the issuing authority. If the employing office
is certifying a foster child or a declaration of common law marriage, the certification or
declaration must be placed in the employee’s permanent official personnel file in lieu of a SF
2809. If an employing office processes SF 2809 transactions through an electronic system, it
must record the document review in a similar fashion.
D. If eligibility verification document(s) are insufficient
If the employing office determines that an eligibility document for any family member is
insufficient, it must provide the employee with a written notice of its initial decision, see
Attachment #3: Sample Letter Information Provided Does Not Verify Family Member Eligibility.
This letter must include an explanation of the employing office’s decision, require the employee
to submit a new SF 2809 listing only verified family members, and provide notice of the right to
a reconsideration of the employing office’s initial decision. The employing office must enroll the
employee and/or verified family members pending any reconsideration request. The employing
office must retain the decision letter in the employee’s permanent records, along with any
response and employing office reconsideration.
II. Reconsideration process
The employing office must establish a reconsideration process for its initial family member
eligibility decision. In addition, the employing office is responsible for performing all
reconsiderations of FEHB Carrier determinations regarding the addition of a family member to
an existing Self and Family enrollment. The reconsideration review and decision-making process
must be conducted by an employing office representative (e.g., Supervisor or Manager), who is
at least one level above the employing office representative that made the initial determination.
For reconsideration requests of initial decisions made by the FEHB Carrier, an employing office
representative must review and make the final determination
The employee must file a written request for reconsideration of the initial decision to the
employing office within 60 calendar days from the date of the initial decision letter. See
Attachment #3 Sample Letter Information Provided Does Not Verify Family Member Eligibility
for information that must be included in the reconsideration request.
The employing office may extend the time limit for requesting reconsideration when the
employee shows that he or she was not notified of the time limit and was not otherwise aware of
it, or that he or she was prevented by circumstances beyond his or her control from making the
request within the time limit.