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Answering your questions about Healthcare and Insurance
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Each year OPM releases the new health insurance rates about a month prior to the FEHB Open Season. The FEHB Open Season runs from the second Monday in November through the Second Monday in December. The new rates are generally released by mid-October at http://www.opm.gov/insure/health/rates/index.asp.
The premiums for the FEHB plan you are currently enrolled in are in the brochure you will receive from your plan during the annual Federal Benefits Open Season. The Guide to Federal Benefits is a comparison of the plans and their benefits and premiums. There are a variety of Guides targeted to specific groups of enrollees.
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.
The total premium is the same for all enrollees, but the Government contribution is based on your employment. Some agencies, such as the Postal Service, contribute additional money towards the total premium. As a result, the share you must pay will depend upon your employment status. All Guides are available on this website or through your Human Resources Office.
There is no minimum requirement for the number of HMO options available to enrollees throughout the country. We have encouraged HMO participation in the Program because many of our participants have asked for that choice of health plan. In fact, under the FEHBP, the only types of health plans that can be added to the Program are HMOs. And, HMOs have an annual opportunity to submit their applications to participate in the Program.
If you have HMOs in your local area that do not currently participate in the FEHBP, we encourage you to ask these HMOs to consider the FEHBP market for their geographic areas. New plan application packages for the FEHB Program are available at www.opm.gov/insure/health/carriers/index.asp. Applications are due to OPM by January 31 of each year for the next contract term.
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