Expert's View

While there are probably a number of things that could be said about the dental and vision parts of this year’s Federal Benefits Open Season, none of them have generated the amount of heat that the Federal Employees Health Benefits program has. So I’m going to spend my time on that.


The greatest concern of FEHB enrollees has been the significant increases in premiums for some of the most popular plans and options. The average premium increase is 7.4 percent, employer and employee contributions combined. Because of the way the employer contribution is capped the average increase in the employee share works out to 8.8 percent. But even that doesn’t tell the whole story. For non-postal enrollees, the premiums for standard BC/BS self enrollments will be going up 15.1 percent and family 12.4 percent, while even the basic self and family options will go up 9 percent.

Only APWU and GEHA have moderate changes. APWU is going up 4 percent in its high self and family options, while GEHA in its high option self is reducing premiums by 13.1 percent and only increasing its family by 0.04 percent. However, its standard self and family will each rise by 8 percent. Mail Handlers standard will go up 28 and 42.2 percent, and NALC high 20.1 and 18.9 percent.

Note: The increases for postal workers are lower because the Postal Service pays a higher percentage of their premiums.

The assumption when premiums spike is always that someone (OPM) wasn’t minding the store. However, what enrollees are generally unaware of is that each plan in the FEHB is experience rated. In other words, next year’s premiums are based on last year’s costs plus a factor that represents anticipated increases in medical costs, which, as everyone knows by now, continue to soar.

Even if you don’t buy that explanation, it doesn’t change anything. You are still faced with the need to consider what your medical needs (and those of any family members) will be for the coming year and compare the coverage and cost of a variety of plans. Since the FEHB has no restrictions on age, health or preexisting conditions, you can select a plan based on your specific needs for a single year. For example, if you know that you are facing major surgery or treatment for cancer, you can select a plan that not only provides extensive coverage but also includes your preferred doctors and hospitals. Of course, once you have narrowed down your search, you’ll need to see which among them also offers the best catastrophic coverage.


FYI: OPM now has a handy website where you can generate a list of plans available in your ZIP code, so you can do a side-by-side comparison. You’ll find it at