Click here to skip navigation
This website uses features which update page content based on user actions. If you are using assistive technology to view web content, please ensure your settings allow for the page content to update after initial load (this is sometimes called "forms mode"). Additionally, if you are using assistive technology and would like to be notified of items via alert boxes, please follow this link to enable alert boxes for your session profile.
OPM.gov Home  |  Subject Index  |  Important Links  |  Contact Us  |  Help

U.S. Office of Personnel Management - Recruiting, Retaining and Honoring a World-Class Workforce to Serve the American People
Advanced Search

This page can be found on the web at the following url:
http://www.opm.gov/insure/life/fegli/sf2822.asp

Insurance Programs

  1. New / Prospective Employees
  1. Federal Employees
  1. Retirees / Survivors
  1. Benefits Officers
Skip Left-NavigationSkip Navigation

Life

Request for Insurance

SF 2822
May 2011
Use:

Federal employees use this form to obtain life insurance coverage by providing medical information.

Electronic Copies:

PDF Fillable Version Adobe Acrobat Version [232 KB]

Paper Copies:

Paper copies of this form are not available. You MUST use the downloadable Adobe Acrobat PDF version.

 
PDF Help U.S. Office of Personnel Management 1900 E Street, NW, Washington, DC 20415 | (202) 606-1800 | TTY (202) 606-2532