Dive Brief:
- The Federal Employees Health Benefits Program is getting a major update for 2016: a new self-plus-one option, in addition to the former categories of self-only and self-and-family.
- The move was set in motion through a December 2013 budget deal. The Office of Personnel Management (OPM) is now moving forward as announced in the "FEHB Program Carrier Letter" dated March 13.
- The proposed rule, which was released in December 2014, stated that premiums would be lower for the plus-one option than for the family option, and that premiums would likely go up for the family plan.
Dive Insight:
The move is sure to be popular for many federal employees, but less so for those with children who can now expect to pay higher rates. As FedSmith.com notes, critics had been commenting for years that the current system, which required a couple to pay the same rate as an entire family, is not reasonable.
The OPM letter adds that benefits that vary between enrollment type, such as catastrophic maximum, deductibles and wellness incentives, should be for dollar amounts that are less than or equal to corresponding benefits under self and family enrollment, while other benefits, such as the amount of copays and coinsurance amounts, are likely to be the same no matter whether the insured uses the self-plus-one option or the family plan.