Information on Self Plus One Pending

FEHB enrollees could soon find out more about the new coverage option to be available in the program in the 2016 plan year, self plus one. OPM earlier instructed carriers to conduct two separate educational campaigns on the new option, the first one focusing in particular on current family coverage enrollees who would be most likely to be interested in it. That mainly would be married couples with no children under the age 26 eligibility cutoff but also would apply to a single parent with one eligible child. Such enrollees traditionally have had to pay for family coverage at the same rates as enrollees with multiple eligible family members, long a sore point for them. OPM told carriers to stress that the second person can only be someone eligible under standard family coverage rules, which aren’t changing, and that any additional family members won’t be covered even if they meet those rules. Self plus one rates are to be lower than family coverage rates–as they are in the separate FEDVIP program, which has had a self plus one option since its inception–but how much lower won’t be known until 2016 premium rates are announced, probably in September. OPM has estimated that as many as 30 percent of all FEHB enrollments consist of just the enrollee and one eligible family member. Those in that situation won’t be switched from family coverage to self plus one automatically; they will have to elect that change during the upcoming open season.