FEGLI 2004 Open Season Materials
ORDER FORM
Benefits Officer’s Name:
*
:
Your Agency Headquarters Federal
______________________________
Ship To (Name): ____________________________________
Agency/Bureau: _____________________________________
Address __________________________________________
PRINT CLEARLY!
Place Orders By July 30 to ensure receipt
by Open Season
Email Orders To:
agencyhelp@fegli2004.com
or
__________________________________________
Fax Orders To:
(973) 667-1677
__________________________________________
___________________________________________
Number of Eligible
Employees at this Location: ____________
Daytime Telephone: _________________________________
See BAL 04-205 for more details on the ordering
Email Address: _____________________________________
process
*NOTE: Must be a street address. Shipments cannot be made to Post Office Boxes.
If you have multiple shipping locations, you must submit a separate form for each location.
DESCRIPTION GUIDELINES QUANTITY
ENROLLMENT MATERIALS EMPLOYEES MUST RECEIVE
(s)
FEGLI 2004 Open Season Enrollment Packets
*Check your choice of distribution option
• ONE per eligible employee
1. Send to employees’ home addresses
5 for details.
Provide mail file to Federal Direct by
07/30/04. See BAL 04-20
•
2. Send to the following vendor for mailing:
Name/Address:____________________________________
_______________________________________________
_______________________________________________
the left.
If you wish to have your own vendor mail
the packets to your employees, you must
provide the vendor’s name and address to
With this option, you are
responsible for the cost of the vendor
mailing to your employees.
•
3. Send to location shown at the top of this form
• You will distribute the materials to your
employees. ALSO order a few extras to
have at the agency in case employees
lose theirs (even if you use a vendor)
SUPPLEMENTAL MATERIALS
Posters
• ONE poster per 50 employees
• Small (8 ½ x 11)
• Large (17 x 23)
Tent Cards
200 maximum per location •
Select Format: CD-ROM (1) VHS (2)
Videos
•
video to view individually.
You may want to order sufficient copies
so that employees can visit their local
human resources office and borrow a
)
Select Format: CD-ROM (3) VHS (4)
Videos (Closed Caption
VHS
Meeting in a Box
(includes PowerPoint presentation and Speaker’s Notes on CD-ROM
and hard copy, One Enrollment Packet, One Video, Email
Messages, and Two Small Meeting Posters)
Select Video Format: CD-ROM Closed Caption
•
Informational Meetings
•
ONE per agency location holding
The video included in the Box is the same
as the above video
)Extra Meeting Posters (to announce Date/Time of Meeting
• ONE poster per 50 employees
• Small (8 ½ x 11)
• Large (17 x 23)
Open Season Election Forms (FE-2004)
Forms are already included in Enrollment
Packets. You may order a few extras.
•
th
)FEGLI Program Booklets -- 50 Anniversary Edition (FE-76-21
• Order ONLY for anticipated new hires
through the end of 2004.
