Self Plus One
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If you are an annuitant or an employee who waived premium conversion, you can decrease enrollment at any time. If you are an employee who participates in premium conversion, your youngest child turning age 26 is a
qualifying life event (QLE) permitting you to change your FEHB enrollment outside of Open Season. With this QLE, you can decrease your enrollment. You do not need to wait until the next Open Season to make this change; however, you need to request the change to decrease your enrollment within 60 days of your child turning 26
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An enrollee is not required to enroll in Self Plus One. If an enrollee wants to stay in his or her current plan and enrollment type, the enrollee may remain in Self and Family and does not need to do anything during Open Season. Alternatively, the enrollee may select a new plan option with a lower enrollee share. OPM encourages enrollees to review their enrollment options each Open Season before making an enrollment decision.
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Yes, there are nationwide plans available with lower enrollee shares for Self Plus One than Self and Family.
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Annuitants are allowed to decrease enrollment at any time. This means that if you have a Self and Family enrollment and you decide you would like to change to a Self Plus One enrollment, you may do so throughout the year.
If you have a Self Only enrollment, however, you must experience a Qualifying Life Event in order to change to Self Plus One. These are events such as marriage, divorce, or a family member’s loss of coverage under another health insurance program. For a full list of allowed QLEs, please view the
SF 2809.
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You should determine your eligible family members and decide which enrollment type is best for you. A Self Plus One enrollment type will cover you and one eligible family member. You will want to pay close attention to the benefits and rates in both the plan you currently have and other FEHB plans available to you. OPM provides materials to help you make this important decision. Visit
https://www.opm.gov/healthcare-insurance/healthcare/.
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Self Plus One is a new enrollment type in the Federal Employees Health Benefits (FEHB) Program that allows you to cover yourself and one eligible family member you designate to be covered.
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As an active employee, you must experience a Qualifying Life Event (QLE) in order to change your enrollment outside of Open Season. These are events such as marriage, divorce, the birth or adoption of a child, or a family member’s loss of coverage under another health insurance program. For a full list of allowed QLEs, please view the
SF 2809.
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It will be very important during Open Season to look at the rates for the plan you are in and for other plans as well. It may be possible to save money by enrolling in a Self Plus One enrollment, but you should review your health benefit needs and the available FEHB plans to determine which plan is best suited to meet your needs.
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No. In order to decrease your enrollment to Self Plus One you will need to make an enrollment change during Open Season or in conjunction with experiencing a Qualifying Life Event. Your employing (or retirement) office will not change your enrollment unless you request it.
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