Q. How can I find out the amount
of my FEHB premium?
A. The premiums for the FEHB
plan you are currently enrolled in are in the brochure you will receive
from your plan during the annual FEHB Open Season. The Guide
to FEHB Plans is a comparison of the plans and their benefits and premiums.
There are a variety of Guides targeted to specific groups of enrollees.
The different Guides are:
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.
Q. The Guide to FEHB Plans 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?
A. 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. For example, in 2009, the biweekly
average premium amounts are $214.35 for Self Only and $484.24 for Self and Family
coverage. Accordingly, the maximum biweekly Government contribution is $155.66
for self and $352.56 for family.
Q. When my youngest child turns
age 22 and only my spouse and I are covered under my Self and Family enrollment,
will my premiums decrease? Can I enroll in a "self-and-spouse" enrollment?
A. Your plan's premiums will
not decrease due to your family getting smaller, just as the premiums did
not increase because you added children and your family grew. The law permits
you to choose between Self Only coverage or self- and-family coverage only.
Other coverage types -- such as self-and-spouse, self-and-one-child [two
children, three children, etc.], and self-plus-one -- are not available.
Q. I am under age 65 and do
not have Medicare. Why should my premium include Medicare enrolled annuitants?
Why can't they have a separate enrollment category for people with Medicare?
A. Enrollees may choose from
Self Only coverage or Self and Family coverage. Other coverage types --
such as Medicare enrolled and/or Medicare eligible -- are not available.
Data shows that there is not a significant difference in the cost to the
FEHB Program between employees and enrollees covered by both Medicare and
an FEHB plan. The cost to employees or Medicare-eligible enrollees would
not reduce substantially be creating a separate Medicare category.
Interestingly, your enrollees often benefit from older enrollees' Medicare
enrollment. This is because substantial savings can be realized from an
aggressive coordination of benefits program between the plan and Medicare;
the savings are applied to all enrollees' rates.
Q. My husband has made the necessary
arrangements for me to be able to continue the health insurance should he
die before me. Will I have to pay more or will the premiums be the same?
A. Your premiums will not
change. The enrollment will be changed to your name and changed to a self
only enrollment if there are no other eligible family members.
U.S. Office of Personnel Management 1900 E Street NW, Washington, DC 20415 | (202) 606-1800 | TTY (202) 606-2532