Please rate Benefeds Belated Enrollment Ben09007 V. 2 0924
Note: If you did not experience one of the reasons listed below, we are unable to approve this request.
Use: use this form only to request approval for a belated FEDVIP enrollment, change to an existing FEDVIP enrollment, or cancellation of your FEDVIP enrollment.
If approved: if your request is approved, you will have 30 days from the date on your approval letter to contact FedPoint to execute your request.
Past due premiums: if the change results in past due premiums, federal law states that these premiums must be paid by direct bill.
Incomplete forms: incomplete forms will not be processed.
| Question | Answer |
|---|---|
| Form Name | Form BEN09007 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 27 |
| Avg. time to fill out | 5 min |
| Edition | 0924 |
| Where to send | BENEFEDS, P.O. Box 797, Greenland, NH 03840-0797; Fax: 1-877-827-3291 |
| Matches the agency's file | Yes, checked October 4, 2026 |
| Other names | BEN09007, BEN 09007, FEDVIP Belated Enrollment/Change Form, BENEFEDS belated enrollment |
| Official source | Form BEN09007 (Rev 0924), BENEFEDS |
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Please rate Benefeds Belated Enrollment Ben09007 V. 2 0924
