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Frequently Asked Questions Insurance

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The Guide to Federal Benefits for Federal Civilian Employees says the Government pays "72 percent of the average premium" toward the cost of my health insurance premium, but not more than 75 percent of the total premium for any plan. What is the average premium?

The average premium is a program-wide average of the enrollment charges for all individuals who are eligible to receive a Government contribution, with separate determinations for Self Only and for Self and Family enrollments.

The average premium is recalculated every year. 

Per FEHB law, the government will pay the lesser of: 75% of the carrier’s total premium, or 72% of the average premium.  The enrollee is responsible for the difference between the government contribution and the total premium.

If the average premium increases, the maximum government contribution also increases.

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