Fillable 12 601d (U.S. Office of Personnel Management)

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12 601d (U.S. Office of Personnel Management)

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Federal Employees Health Benets
Initial Enrollment Opportunity
for Tribal Employees
Initial Enrollment Opportunity:
Eective Coverage Date:
Contact:
For more information:
www.opm.gov/tribalprograms
U.S. Oce of
Personnel Management
Federal Employees Health Benets
Initial Enrollment Opportunity
for Tribal Employees
Initial Enrollment Opportunity:
Eective Coverage Date:
Contact:
For more information:
www.opm.gov/tribalprograms
U.S. Oce of
Personnel Management
Federal Employees Health Benets
Initial Enrollment Opportunity
for Tribal Employees
Initial Enrollment Opportunity:
Eective Coverage Date:
Contact:
For more information:
www.opm.gov/tribalprograms
U.S. Oce of
Personnel Management
Federal Employees Health Benets
Initial Enrollment Opportunity
for Tribal Employees
Initial Enrollment Opportunity:
Eective Coverage Date:
Contact:
For more information:
www.opm.gov/tribalprograms
U.S. Oce of
Personnel Management
Federal Employees Health Benets
Initial Enrollment Opportunity
for Tribal Employees
Initial Enrollment Opportunity:
Eective Coverage Date:
Contact:
For more information:
www.opm.gov/tribalprograms
U.S. Oce of
Personnel Management
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12 601d (U.S. Office of Personnel Management)

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Completed 22 July 2020

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