Fillable Printable OPM Form 1482
Fillable Printable OPM Form 1482
OPM Form 1482
7.
9.
OPM suspends applicable annuity withholdings for Basic, Option A and Option C for all annuitants who are reemployed in positions eligible for
FEGLI coverage. You must withhold premiums for Basic, Option A and Option C if the reemployed annuitant has that coverage as an annuitant, is
eligible for the coverage in the reemployed position, and does not waive the coverage. If the reemployed annuitant waives Basic as an employee, all
life insurance terminates, both as an employee and as an annuitant. If the reemployed annuitant waives Option A or Option C as an employee, that
coverage as an annuitant also terminates.
6.
Reemployment of annuitants under conditions which do not
terminate annuity requires appropriate offset against salary. You
must reduce the salary.
Complete this form for all reemployed annuitants who are entitled to elect or continue life insurance coverage as employees.
If the reemployed annuitant waives Basic, all life insurance coverage stops, both as an employee and as an annuitant.
Return completed form and send other notifications to:
Check the appropriate box:
Federal Employees' Group
Life Insurance (FEGLI) Program
Agency Certification of
Status of Reemployed Annuitants
Salary reduced by $ per pay period.
1. Reemployed annuitant's name (Last, first, middle) 2. Date of birth (mm/dd/yyyy)
5. CSA or CSI number (if known)
Salary not reduced Explain in Remarks Section.
Reemployment allows Life Insurance coverage.
Reemployment within 3 calendar days without a break in service.
Option B
10.
If the reemployed annuitant elects Option B as an employee and later decides to continue it as an annuitant, he/she must complete an SF 2817
waiving Option B. Unlike with Basic, Option A and Option C, that action does not cancel the annuitant Option B. Instead, it restores the
Option B suspended as an annuitant. You must notify OPM about this action so that we can resume Option B premium withholdings from the
annuity.
If the reemployed annuitant wants to cancel Option B held as an annuitant, he/she must send a signed letter to OPM, giving his/her name, date of
birth, annuitant claim number, and an explanation of exactly what he/she wishes to do.
I certify that the above information correctly reflects official records and that the employee named either elected or waived FEGLI coverage(s) as
shown above.
Signature of authorized agency official
Name and title of authorized agency official
Continuing as an annuitant with withholdings made from annuity.
Elected coverage as an employee. Please suspend coverage as an annuitant.
Date deductions from pay began(mm/dd/yyyy)
Not eligible. Uncancelled waiver of Option B is on file.
Name and address of agency, including ZIP code
12. Remarks
U.S. Office of Personnel Management
Previous editions are not usable
U.S. Office of Personnel Management
Retirement Operations Center
P.O. Box 45
Boyers, PA 16017-0045
OPM Form 1482
Revised April 2000
Check, if applicable:
8. Type of appointment
Basic, Option A and Option C
Email address
11.
Notes:
Date (mm/dd/yyyy)
(1)
(2)
Date (mm/dd/yyyy)
May Be Locally Reproduced
3. Social Security Number 4. Reemployment date (mm/dd/yyyy)
If the reemployed annuitant continues any life insurance as an employee, the Office of Personnel Management (OPM) will suspend the
annuity withholdings for that coverage.
If the reemployed annuitant waives any life insurance as an employee, he or she has also waived that coverage as an annuitant. (Option B
is an exception. See Item 10.)
The reemployed annuitant has a choice: If he/she has Option B as an annuitant and does nothing, he/she will continue to have Option B as an
annuitant. OPM will continue to withhold Option B premiums from his/her annuity. If he/she has Option B as an annuitant but wants to carry it as
an employee, he/she must elect Option B on Standard Form (SF) 2817, Life Insurance Election within 31 days of reemployment. Then you must
withhold Option B premiums from his or her pay. He/she must be sure to sign the SF 2817 for ALL coverage he/she has (including coverage held
as an annuitant), and not just for Option B.
Telephone no. (include area code)Fax number (include area code)
