Dive Brief:
- Rates in the health insurance program for federal employees and retirees will see changes as a result of the new "Self Plus One" option. Rates for self and family premiums are expected to increase by an average of 7% in 2016, while those who switch from family coverage to the new option will save an average of 6%.
- The Office of Personnel Management published its final rule Thursday detailing how the new option is expected to impact premiums, apart from how overall healthcare costs will impact premiums.
- The actual plan rates for 2016 are slated to be announced in late September following OPM/insurer negotiations.
Dive Insight:
The reported estimates were developed two years ago for the Congressional Budget Justification and shown in the final rule to aid in modeling the potential effects of the new option, the OPM told the Washington Post, so adjustments can certainly be expected. "We will have more information on the differentials between enrollment categories when the 2016 rates are released,” the OPM said.
The two-year-old projections suggest the new option will have a neutral budget impact, "though this is subject to uncertainty," the rule adds.
The OPM aims to keep the self-plus-one premiums lower than family premiums, which could be an issue because the self-plus-one option is likely to have a disproportionate share of retirees with higher-cost healthcare, the report notes. The OPM has implemented a one-year policy requiring self-plus-one rates not to exceed family rates. "However, because of the way the premium-sharing formula works, it is possible that the enrollee share of some plans for self-plus-one will exceed the family rates," the Washington Post notes.