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OPM.gov / Frequently Asked Questions / Insure FAQ / Health
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Health

Questions and answers

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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