Variable Premiums Idea Leaves Many Questions

Yet another proposal would allow carriers to charge higher premiums for enrollees who use tobacco or who do not participate in employee wellness programs. That would represent a change from the FEHB’s fundamental design of providing equal premiums to all who are in a particular plan regardless of personal situations. Many plans offer financial incentives such as reduced copayments and deductibles for enrollees to participate in such programs—and OPM in recent years has been urging them to do more–but there currently is no punitive element for not participating. Even if it were accepted, it would take time to work through practical issues such as how much higher the premiums might be, what level of tobacco use if any would be acceptable or how that would be verified, the standards for determining who should participate in what type of wellness program, or what level of participation would be needed to avoid the premium surcharge.