539 Insurance Forms

539.1 Filing

539.11 SF 2817, Life Insurance Election (FEGLI)

File PART 1 of SF 2817 in the employee’s OPF and destroy PART 2 after personnel action has been processed and verified. PART 3 is the employee’s copy.

539.12 SF 2821, Agency Certification of Insurance Status

File 1 copy (PART 3). The original (PART 1) is forwarded either to OPM or OFEGLI depending upon the type of employee separation. If the employee is not eligible to continue coverage, the original (PART 1) and duplicate (PART 2) are given to the employee.

539.13 SF 2823, Designation of Beneficiary

File the original and give the employee a duplicate. All prior designations are retained in employee’s OPF. Upon the employee’s retirement, all SF 2823 and SF 54 forms are removed from the official personnel folder and forwarded to OPM.

539.14 SF 2822, Request for Insurance

Notify the employee of OFEGLI’s decision and file the form returned by the OFEGLI (SF 2822) in the employee’s official personnel folder.

539.2 Privacy Act Considerations

539.21 Handling and Disclosing Information

Life insurance records contain information about individuals. As such, they are handled and disclosed only in accordance with the Privacy Act and implementing instructions.

539.22 Records Maintenance

An individual’s life insurance records and related correspondence are maintained within the Postal Service in one of two ways: either in the personnel area as part of the privacy system entitled USPS 120.070, Personnel Records — General Personnel Folders (Official Personnel Folders and Records Related Thereto) or in the Eagan ASC as part of the privacy system entitled USPS 050.020, Finance Records — Payroll System. Employees making formal privacy requests specifically for access to or update of these records direct their requests to the head of the installation where employed. Retired employees direct their requests to OPM.

539.23 Employee Retires

When an employee retires, copies of life insurance records are sent to OPM. Retired employees making privacy requests specifically for OPM records direct their requests to the:

BOYERS PA 16017–0045