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Ohio Police & Fire Death Benefit Fund Recipients

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The State of Ohio offers health benefits to Ohio Police & Fire (OP&F) Death Benefit Fund recipients, such as medical; which includes behavioral health, prescription drug and wellness; dental and vision.

MyBenefits Guides

MyBenefits Guide – From July 1, 2022 – June 30, 2023
Ohio Police & Fire Death Benefit Fund Recipients 2020-21 MyBenefits Guide (pdf)

MyBenefits Guide – From July 1, 2021 – June 30, 2022
Ohio Police & Fire Death Benefit Fund Recipients 2021-22 MyBenefits Guide (pdf)

Supporting Forms

Benefits Enrollment/Change Form (ADM 4717D ) – For adding or removing dependents to/from benefits coverage during Open Enrollment.
Benefits Enrollment/Change Form (pdf)

Change in Status/Qualifying Events Matrix – For adding or removing dependents to/from benefits coverage throughout benefit year.
Change in Status/Qualifying Events Matrix (pdf)

Dependent Student Status Certification Form (ADM 4729) – This form is to be completed when a currently enrolled dependent turns 19 years old, a 19–21-year-old dependent is being enrolled in coverage, or when the document is requested over the course of an audit.
Dependent Student Status Certification Form (pdf)