Form FE-6, Claim for Death Benefits, Federal Employees' Group Life Insurance Program

What is FE-6?

Who needs to file FE-6?

When to file FE-6

Documents you need

• A certified copy of the death certificate showing the cause and manner of death. Only one is required, so skip it if another claimant is already sending one.
• A copy of the funeral home assignment, if you signed a document authorizing OFEGLI to pay a funeral home directly.
• Proof of the accident (police reports and other supporting documents), if the insured was an active employee who died in an accident and you claim accidental death benefits.
• A copy of the court appointment papers, if you are filing on behalf of the estate.
• If a trust is designated: a notarized statement that the trust is still in effect and you are authorized to act under it, plus a copy of the trust document.
• A copy of the page naming you as successor trustee, if you are not the original trustee.
• A copy of the Power of Attorney papers for the beneficiary, if you submit the claim under a POA.
• Form W-8BEN (individuals) or W-8BEN-E (entities), if you are not a U.S. citizen, U.S. resident alien or other U.S. person for tax purposes.

How to fill out FE-6

1. 1

   Confirm this is the right form

   Use Form FE-6 only for the death of a Federal employee, annuitant or compensationer. For a dependent or an Option C-Family Benefits claim, use Form FE-6 DEP.

2. 2

   Complete Part A about the insured

   Enter the insured's full name, date of birth and date of death (mm/dd/yyyy), Social Security number or FEGLI claim number, and the last agency employed in. Answer items 6 and 7 on federal retirement and Federal Worker's Compensation, giving the claim number or effective date if Yes.

3. 3

   List the insured's marriages in Part B

   Enter how many times the insured was married, including you if married at the time of death. For each marriage give the spouse's name, check Death or Divorce, and enter the date it ended (mm/dd/yyyy).

4. 4

   Complete Part C if you are the widow or widower

   Give the date, place and officiant of your marriage to the insured, whether you were divorced at the time of death, and the date and place of divorce if so. Then list all of your own marriages with how and when each ended.

5. 5

   Fill in Part D next of kin

   Everyone except the widow or widower completes it. List the insured's living children (not step-children) with relationship, age and address. If there are none, list the parents, and if both died first, other next of kin who may inherit. Then list children who died before the insured and any grandchildren.

6. 6

   Complete Part E for the estate

   If the estate is entitled, say whether a court has issued or is expected to issue an appointment of an executor or administrator. If yes, give their name and address and attach the court appointment papers.

7. 7

   Answer Part F additional questions

   Check Yes or No on whether you signed a funeral home assignment, and attach a copy if Yes. Check Yes or No on accidental death benefits; if Yes, submit coroner's and police reports, news clippings and other available reports.

8. 8

   Choose your payment options in Part G

   Payment is through a Total Control Account by default. Check the box for a free TCA Visa debit card if you want one, and the Digital TCA Option box with your email address or mobile phone number if you want the electronic package.

9. 9

   Enter your information in Part H

   Print your name, relationship to the insured, date of birth, address, phone number and your Social Security number or Estate/Trust/Tax ID#. Everyone must complete this part.

10. 10

    Read the certifications and sign

    Cross out Item 2 if the IRS has notified you that you are subject to backup withholding, and Item 3 if you are not a U.S. person, then attach Form W-8BEN or W-8BEN-E. Sign and date; a Power of Attorney or Guardian signs "on behalf of" the claimant. Write "check" beneath your signature to request a check instead of a TCA.

11. 11

    Review, download and assemble the package

    Check every part for missing information and initial any corrections. Download or print the completed PDF from FillingPDF, add the required documents and send pages 5 through 8 as described under How to submit.

How to submit FE-6

Common mistakes to avoid

• Leaving Part H unsigned: the form says a valid signature is required for the claim to be processed.
• Using Form FE-6 for a dependent or an Option C-Family Benefits claim, which require Form FE-6 DEP.
• Sharing one form among several claimants when each claimant or beneficiary must complete their own.
• Using a previous edition; the form states not to use previous editions.
• Returning the form with missing or incorrect information, which the form says delays the claim, or leaving errors uncorrected instead of correcting and initialing them.
• Listing step-children in Part D, where the form says they are not eligible.
• Faxing the form before a certified death certificate has been submitted, since fax is allowed only after that.
• Not crossing out Item 2 when the IRS has notified you that you are subject to backup withholding, or Item 3 when you are not a U.S. person.
• Wanting a paper check but not writing "check" beneath "Your Signature"; otherwise the payment is made through a Total Control Account.
• Claiming accidental death benefits when the insured separated or retired before the accident; OFEGLI cannot consider that claim.