Valuable as FEHB and PSHB are, you must take the initiative to get informed and choose wisely to get the most from these programs. Image: Minerva Studio/Shutterstock.com
Updated for the 2025 Plan Year: The 2025 plan year marks the most significant change in federal employee and retiree health insurance coverage since the Federal Employees Health Benefits program was created decades ago.
For all that time, the FEHB has been the sole program, applying both to employees and retirees of congressionally funded federal departments and agencies and to those of the self-funding and U.S. Postal Service. However, under terms of a 2022 Postal Service reform law, 2025 marks the launch of the new, largely parallel, Postal Service Health Benefits program for the postal population.
Note the qualifier “largely.”
The PSHB has some notable differences, as described below, including a smaller number of available plans and a general requirement that to be eligible for PSHB as retirees, those who retire from the USPS after 2024 must enroll in Medicare Part B—and pay its separate premiums—when they become eligible, typically at age 65.
However, the programs have important similarities, including a structure that for years has been held up as a model of employer-sponsored insurance—solid coverage at a competitive cost, a wide range of plan choices, no limits or waiting periods to enroll, and eligibility for most to continue coverage in retirement with the government paying as much toward premiums as for active employees.
In the most recent survey of federal employee views of their benefits—taken in 2023, before the launch of the PSHB—the FEHB was ranked as important or extremely important by 90 percent; of the rest, almost all were getting health coverage elsewhere, such as through a spouse’s employment. Further, 95 percent said it meets their needs to a moderate or great extent, nearly as many said that they considered it important or very important to them, and 66 percent rated it a good or excellent value.
One especially telling result was that while 69 percent said the availability of health coverage influenced their decision to go to work for the government, 78 percent said it influences their decision to stay.
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That’s not to say the program is perfect.
While the government pays about 70 percent of the total premium cost for both active employees and retirees, some private sector employers pay more, at least for certain categories of enrollees. Also, there are some gaps in coverage, and average premiums increase yearly—steeply, in recent years.
The average enrollee premium in the FEHB rose 13.5 percent for 2025 over 2024, following average increases of 8.7 and 7.7 percent for 2023 and 2024. Out-of-pocket costs such as deductibles and copayments—which also must be considered along with premium costs when deciding on a plan—have remained about the same, though.
Average increases for 2025 in PSHB plans paralleling FEHB offerings were 11.1 percent. The difference was largely due to some of the costs of postal retirees being shifted onto Medicare and to demographic differences which in turn affect rates of claims.
Still, it pays to compare.
Within those averages, some plans held premiums essentially flat or decreased them a bit, while in others the increase was even larger. Premium rates for both the FEHB and PSHB are at www.opm.gov/healthcare-insurance/healthcare/plan-information/premiums.
(In the separate Federal Dental and Vision Insurance Program, average premiums for dental plans increased by 3 percent and average premiums for vision plans increased by 1 percent. That program offers similar choices during the open season, except that retirees may also newly enroll in the FEDVIP program. See www.opm.gov/healthcare-insurance/dental-vision.)
“Major cost drivers of the program generally align with those in the commercial market. The premium increases are due to the impact of price increases by providers and suppliers, increased utilization of certain prescription drugs, and behavioral health spending. Industry-wide cost pressures affect FEHB and PSHB rates similarly,” the Office of Personnel Management said in announcing the 2025 premium rates.
Cost is a major reason for reexamining one’s health insurance coverage, of course. In the benefits survey, when asked why they considered changing health plans, each of employees’ top three reasons involved cost: of premiums, of copayments, and of deductibles.
But terms of coverage also require attention in the open season. While all plans must comply with certain general requirements, there is much variation among them—and terms do change year to year, as described below.
It’s up to you to take the initiative to get informed and choose wisely…
This report is designed to help you do just that.
The first step is to shore up your understanding of your health insurance.
While that may seem unnecessary—especially if you have been in the program for many years—there could well be important features of the program that would benefit you, but which you simply have not paid sufficient attention to.
The reality is, many treat their health insurance as a file it and forget it benefit.
Some have been with the same plan much or even all of their careers and pay little attention during open season beyond a look at the new premium rates and at any major changes in coverage in their current plan. Traditionally, only about 5 percent of FEHB enrollees change plans in an open season.
The launch of the PSHB will spur a higher level of attention for 2025 among Postal Service employees and retirees, especially for those enrolled in 2024 in FEHB plans that have no parallel in the PSHB (there is a default mechanism for continued coverage of those in that situation but who make no election, as described below).
Even if you are happy with your current plan, don’t overlook how a plan evolves over time, due to new laws and to decisions by the Office of Personnel Management, which oversees the program. Don’t make the mistake of thinking that your coverage next year will be just like this year.
In recent years, the OPM has emphasized controls over prescription drug costs; expansion of telehealth services; increases in mental health, anti-obesity, fertility and maternity care; and incentives to participate in wellness programs and to better manage chronic conditions. Meanwhile, nearly every year some plans newly join or existing ones expand their coverage areas, opening up new possibilities.
Beyond comparing premium and coverage terms in the plans available, don’t neglect to consider your enrollment type: self-only, self and family or self plus one. While there can be exceptions, as explained below, self plus one generally is less expensive than family coverage within a plan. Yet there still are many thousands of family enrollments covering only two people, more than a decade after the introduction of self plus one, simply because of lack of attention paid.
Once you’ve educated yourself, be purposeful in making your choices. This applies not only during open season but also potentially outside it when certain life events occur such as marriage or the birth of a child, when you could benefit from changing your health plan as well as adding family members.
Staying with what you already have is a decision too, and it may well be the best for you. But whatever you do, make sure that decision is made in a thoughtful way.
Understanding the FEHB and PSHB
A hallmark of the FEHB, and now of the PSHB as well, is the wide range of choice in comparison to other employer-sponsored health insurance. That provides eligible persons with the opportunity to select the coverage that best meets their personal needs and budgets. For 2025, the FEHB program has 42 participating carriers offering a total of 130 plan options and the PSHB program has 30 carriers offering 69 plan options.
In both programs, while some plans are national in scope, most are health maintenance organization plans available only within defined regions. Some plans offer a choice of two levels with differing cost and coverage terms, and/or a high-deductible or consumer-driven design.
Altogether, some 8.2 million people are covered, a number about evenly split between enrollees and covered family members. Almost all federal employees are eligible to participate, and most retirees also remain eligible, so long as they were covered by either the FEHB or the PSHB for the five consecutive years before retiring on an immediate annuity (there are limited exceptions to that requirement).
Premiums for retirees are the same as for active employees, although charged on a monthly rather than biweekly basis. The government contributes on average about 70 percent of the total premium. That contribution toward retiree premiums is another feature that compares well with other employer-sponsored health insurance programs—many of which do not allow continued coverage of retirees at all.
Active employees can pay premiums with pre-tax payroll money. Retirees cannot pay through this “premium conversion” arrangement, making the insurance effectively more expensive for them even though the premium rates are the same as for active employees.
The annual open season gives all eligible persons have an opportunity to join the program or make enrollment changes, which also are allowed at other times due to certain life events, as described below.
Eligible family members include spouses and children up to age 26 (no age limit if they were disabled before that age). Foster children can be covered under more limited circumstances: the child must live with you as the sponsor in a parent-child relationship, you must be the primary source of support for the child and you must expect to raise the child to adulthood. You must sign a certification that the foster child meets those requirements.
Verification of family member may be required during initial enrollment and when family members are being added to an existing enrollment due to a qualifying life event such as marriage.
There are three types of enrollments in each program: self only, which provides benefits only to you; self and family, providing benefits to you and all eligible family members; and self plus one, which covers you and only one eligible family member.
Generally, premiums for self-only are the least expensive and for family coverage are the most expensive, with self plus one in between. Be sure to pay close attention to premiums if choosing between self plus one and family coverage for covering only yourself and one other eligible family member. In some cases, a plan’s premium for self plus one is higher than that for family coverage. The reason is that a high percentage of self plus one enrollees are married retirees or older employees with no children eligible for coverage; in the term used in the insurance industry, older people on average “consume” more health care.
You can choose self plus one even if you have more than one family member who would be eligible, but remember that doing so means that the other family member or members would need to get their health coverage elsewhere. You can change the designation of which family member is covered during an open season, or due to certain life events. The change must be consistent with that event, such as adding a spouse as the second person when a covered child ages out of eligibility.
Another favorable feature is that on an enrollee’s death, eligible family members can continue coverage—so long they are eligible for survivors’ benefits due to death in service or upon death of a retiree.
Although there is no precise standard benefit package, all plans must cover basic hospital, surgical, physician and emergency care. Within those requirements, the plans follow certain standards prevailing in the health insurance industry. Further, OPM sets standards for benefits including prescription drugs; coverage of certain treatments; and limits on an enrollee’s total out-of-pocket costs for a year. Certain program-wide requirements are added nearly every year, as described below.
Within those parameters, there is variation in plan designs. You can choose from among managed fee for service (FFS) plans, regardless of where you live, or plans offering a point of service (POS) product and health maintenance organizations (HMO) if you live (or sometimes if you work) within the area serviced by the plan.
· FFS plans reimburse you or your physician or hospital for covered services rather than provide or arrange for services as prepaid plans do. FFS plans allow you to choose your own physicians, hospitals and other health care providers without a referral. Some are open to all enrollees, but others require that you join the organization that sponsors the plan. Some plans limit enrollment to certain employee groups.
· A plan offering a point of service product has rules about doctor choice and access to specialists, but you can choose any doctor you like and see specialists without referrals if you agree to pay more. Membership requirements and/or limitations also apply to any POS product the FFS plan may be offering.
· In prepaid plans, your covered health services are pre-funded by your premium and the government’s contribution toward the cost of your health insurance. Generally, you must use specified plan physicians, hospitals and other providers at designated locations, although care elsewhere may be available after a referral.
An “indemnity benefit plan” is a variant of a fee-for-service plan in which an enrollee may choose any health care provider but may have to pay a portion of the charge and, if it exceeds “usual and customary” rates, the difference.
There are two other major variants. In “consumer-driven” options, enrollees get a sum of money to pay toward health costs, then pay a deductible, and then have standard fee-for-service or HMO coverage. In “high-deductible health plans,” enrollees have a tax-favored account—typically, a health savings account for those not eligible to draw Medicare benefits, and a health reimbursement arrangement for those who are—that can be used to pay the deductible and certain other qualifying health expenses.
General information for the FEHB is at www.opm.gov/healthcare-insurance/healthcare and for the PSHB at www.opm.gov/healthcare-insurance/pshb.
Postal Service Health Benefits Program Special Considerations
The Postal Service Health Benefits program offers largely the same coverage as the FEHB with generally comparable premium rates and similar policies regarding eligibility and other matters.
However, there are several important differences:
· The PSHB has fewer insurance carriers, although it offers plans parallel to those that cover the large majority of FEHB enrollees.
· Those retiring from the Postal Service in 2025 and after generally must enroll (and stay enrolled) in Medicare Part B and pay its premiums to be eligible for PSHB coverage. That does not apply to those retired before 2025, to those still employed by the USPS who reached age 64 or older before 2025, or to post-2024 retirees living overseas or who are receiving care through the VA or Indian Health Service. There is no Medicare Part B enrollment requirement in the FEHB.
· In the PSHB, prescription drug coverage for retirees and their covered family members is integrated with Medicare Part D; in the FEHB, enrollment in Part D is voluntary and generally is declined on grounds that it mostly duplicates prescription drug benefits provided by FEHB plans at an additional cost.
Postal Service injury compensationers are not required to enroll in Medicare Part B to enroll in a PSHB plan, regardless of Medicare Part A entitlement. At retirement, compensationers may have to enroll in Medicare Part B, if eligible, unless they meet one of the above exceptions.
Many FEHB and PSHB plans offer cost savings to their enrollees who are also enrolled in Medicare Part B, such as Part B premium reimbursement, waived deductibles, and waived cost-sharing for certain medical services. Details are in plan brochures; for the PSHB, also see www.keepingposted.org/assets/pdf/pshb-cost-savings-for-medicare-enrollees.pdf.
Note: During 2024, there was a “special enrollment period” in which those already retired from the Postal Service but who had not elected Part B when they became eligible—typically, at age 65—could elect Part B coverage without the surcharge to premiums that typically applies to retirees who do not enroll at their first opportunity.
In the PSHB, Medicare-eligible annuitants and their Medicare-eligible family members receive prescription drug coverage through Medicare Part D—either a standalone prescription drug plan or a Medicare Advantage prescription drug plan. The former provides pharmacy benefits only, while the latter is part of the overall Medicare Advantage package of coverage also including inpatient, outpatient and physician services.
In the fall 2024 benefits open season for 2025, postal employees and retirees moving from the FEHB into the PSHB have the opportunity to choose among the available PSHB plans. Those who make no choice will be transferred by default into the parallel PSHB plan where one exists; where one doesn’t exist, those who make no election will be transferred into the lowest-cost national PSHB plan.
Note: Postal employees and retirees may remain in the FEHB as a covered family member in the enrollment of a spouse eligible for the FEHB through their own federal employment.
Additional information specific to the PSHB is at www.opm.gov/healthcare-insurance/pshb and at www.keepingposted.org/assets/pdf/guide-to-understanding-the-pshb-program.pdf.
The creation of the PSHB did not change eligibility of Postal Service employees and retirees under the federal life insurance, dental-vision insurance or long-term care insurance programs.
Changes in Coverage
In the spring of each year the Office of Personnel Management sets the terms of coverage for the following plan (calendar) year; starting with the early-2024 “call letter” for 2025, those requirements apply to the PSHB along with the FEHB. That begins a process of negotiations between that agency and health insurance carriers over the specifics of coverage and premiums.
Changes in requirements can come in response to trends and developments in health care, to changes in general health care law, or to priorities of the sitting administration. Those changes then become part of baseline requirements for future years, unless changed further.
Details of changes in coverage and premiums, which become effective with the new year, typically are announced about a month in advance of the annual open season that begins in early November. For the 2025 plan year, the open season runs November 11-December 9, 2024.
In recent years, OPM has emphasized cost-containment for the costliest prescription drugs; tighter controls on prescriptions for opioids; greater use of telehealth services; broader fertility, maternity and mental health benefits; and financial incentives for retirees under FEHB to enroll in Medicare Part B through copay, coinsurance or deductible waivers or Part B premium reimbursement.
For 2025, major initiatives affecting both the FEHB and PSHB include: expanded fertility benefits, with multiple national plans offering comprehensive in-vitro fertilization coverage; required coverage of at least one weight loss drug and at least two oral anti-obesity drug options approved by the FDA, plus diet and exercise regimens for those prescribed anti-obesity medications; expanded access to behavioral health services and substance abuse treatment; and expanded maternal health coverage, including for mental health treatment for postpartum depression.
Some significant changes of prior recent years include:
Effective in 2022 were new protections against “surprise billing”: out-of-pocket costs that can arise for example in emergency and other urgent care settings when enrollees don’t have time to check whether facilities are in-network, or when they unknowingly receive care at an in-network facility from providers who are out of network. Also effective in 2022 were new price and quality transparency requirements and expanded coverage for medically recommended foods and for fertility treatments, among other benefits.
For the 2023 plan year, carriers were told to continue the increased levels of telehealth and other services related to the pandemic, including required coverage over-the-counter tests, booster doses, therapeutics, and pharmacy access to therapeutics. OPM emphasized a focus on comprehensive mental health and substance use disorder benefits including ensuring parity with medical and surgical benefits; expanding coverage for infertility diagnosis and treatment including assistive reproductive technology such as in vitro fertilization; and expanded coverage of anti-obesity medication and medical foods for metabolic disorders. OPM meanwhile encouraged, but did not require, carriers to expand coverage for prenatal and postpartum care, fertility treatment and gender affirming care.
For 2024, OPM required carriers to expand coverage for anti-obesity coverage including wellness activities, nutrition counseling and medications; mental health and substance abuse disorder services; prenatal and postpartum care; assisted reproductive technology; and gender affirming care. It also encouraged them to enhance coordination of benefits with the Medicare Part D program—prescription drug coverage that most retirees don’t enroll in because FEHB provides similar coverage—in light of changes to that program including a cap on enrollees’ out of pocket spending under Part D starting in 2025.
Making Health Coverage Decisions
The FEHB and now the PSHB offer eligible persons regular opportunities to change coverage as part of the annual benefits open season. Changes outside of open season also are allowed if an enrollee experiences certain “qualifying life events” as described below.
Newly hired employees may enroll within 60 days of hiring; otherwise, they must wait until the next open season unless they experience a qualifying life event.
Note: Most years, a few plans have dropped out of the FEHB, restricted their geographic coverage area or eliminated an option. If an enrollee affected by a dropout or geographic restriction makes no new election, agencies (or OPM, in the case of retirees) are to automatically enroll them in the lowest cost nationwide plan available. If only their option is being dropped, the enrollee is enrolled by default in the lowest-cost remaining plan option of the same carrier that is not a high deductible health plan.
During Open Season—The benefits open season is an annual opportunity to review your health needs. Open season applies to the FEHB and PSHB and also to the Federal Employees Dental and Vision Insurance Program (FEDVIP) for both active employees and retirees—as well as to the flexible spending account program (FSAFEDS), which is only for active employees. There aren’t any waiting periods or pre-existing condition limitations if you are either a new enrollee or an existing enrollee making a change.
Note: Enrollment, or lack of it, in one of these programs does not affect eligibility to be enrolled in any of the others. Also, it is not necessary to enroll for the same type of coverage—an enrollee could have self only coverage under FEDVIP while having self and family health insurance coverage, for example.
Even enrollees satisfied with their health insurance and FEDVIP coverage can benefit from examining their options in the open season. Plans revise their covered services year to year. Similarly, while premiums on average increase each year, there is wide variation among plans, potentially making a current plan less affordable, or making more affordable a plan an individual previously ruled out as too expensive. Also, in addition to dropouts or coverage restrictions, sometimes plans newly join or broaden existing geographic coverage areas.
FEDVIP plans are more stable but their terms and premiums change somewhat each year too. It’s also important to check how a FEDVIP plan’s benefits would dovetail with any vision and dental benefits offered through a health insurance plan, especially if you are changing one or the other. FEDVIP always pays benefits secondary to your health insurance coverage, to the extent that it includes dental and vision benefits.
Individual health plans provide benefit brochures to their existing enrollees online and/or in paper form, which includes an explanation of benefit changes for the next year and new premium rates. OPM posts those brochures at www.opm.gov/healthcare-insurance/healthcare/plan-information/guides along with plan comparison features, contact information, and other information.
During an open season:
· If you aren’t already enrolled in an FEHB/PSHB plan and/or a FEDVIP plan, you can enroll.
· If you are already enrolled and are happy with your current coverage, you don’t have to do anything. Your enrollment(s) will continue automatically. However, at least be sure your plan is still participating in the program and review its benefits and premiums for the upcoming year.
· If you are already enrolled, but want to make a change, you can change to another plan, change levels of coverage within a plan (for those offering more than one level), or alter your coverage among self only, self plus one or self and family.
If you wish to participate in FSAFEDS in the following year you must enroll (at www.fsafeds.gov) even if you currently are enrolled—enrollments don’t continue one year to the next. You can choose a dependent care account and/or a health care account (note: for FEHB enrollees in certain plans offering similar tax breaks, only a “limited expense” FSA is available).
Further, to take advantage of the allowable carryovers beyond the end of a plan year allowed in each, you must be enrolled in that type of account for the following year. As an enrollee in FSAFEDS, you’ll be able enjoy the lower taxable income benefits and pay for your health insurance and FEDVIP co-pays and deductibles.
Outside Open Season—Outside of open season, you can enroll, change your plan enrollment, change among the coverage options or cancel coverage in certain circumstances. The most common of these are in connection with what are called qualifying life events: a change in family status; a change in employment status; or if you or a family member lose existing health coverage. (In addition, there are some specialized situations in which enrollees may make changes, such as if moving to an area where their current regional plan is not available.)
A change in family status is: marriage, birth or adoption of a child, acquisition of a foster child, legal separation, divorce, or death of a spouse or dependent.
A change in employment status is: you are reemployed after a break in service of more than three days; you return to pay status after your coverage terminated during leave without pay status or because you were in leave without pay status for more than 365 days; your pay increases enough for premiums to be withheld; you are restored to a civilian position after serving in the uniformed services; you change from a temporary appointment to an appointment that entitles you to a government contribution; or you change to or from part-time career employment.
A qualifying loss of coverage is: under another FEHB/PSHB enrollment because the covering enrollment was terminated, canceled, or changed to self only; when enrolled in a prepaid health maintenance organization and you or a covered family member move or change worksite outside of the HMO’s enrollment area; under another federally-sponsored health benefits program; under Medicaid or similar State-sponsored program for the needy; under CHAMPVA, TRICARE, or TRICARE-for-Life; when you had previously suspended your FEHB/PSHB coverage to participate in one of these programs; or when your membership in the employee organization sponsoring the FEHB/PSHB plan terminates under a non-federal health plan.
When one of these events occurs, you may, depending on the circumstances:
enroll;
change your enrollment among the coverage levels;
change your enrollment to another plan or another option within the plan, for plans that have more than one; or
cancel your enrollment.
A change to self only may be made only if the event causes the enrollee to be the last eligible family member under the FEHB/PSHB enrollment. A cancellation may be made only if the enrollee can show that as a result of the event, he or she and all eligible family members now have other health insurance coverage.
If you have self plus one coverage and have more than one family member who would be eligible, you can change the designation of which is covered during an open season, or due to certain life events, so long as the choice is consistent with the event.
If you have family coverage and a life event occurs that causes you to have only one eligible family member remaining—for example, a child aging out of eligibility—a switch from family coverage to self plus one is not automatic. You must change your enrollment.
Note: Similar policies apply under FEDVIP.
Issues to Consider—Within the general structure of FEHB and PSHB, there is wide variation among how plans operate and exactly what they cover, under what terms. Failure to consider your health plan choices—whether during an open season or if you have the opportunity due to a qualifying life event—could leave you without the health care services or supplies you need or paying higher premiums than are necessary. Dental and/or vision coverage can fill in the gaps of any coverage you now have, or pay for services you now don’t get.
One question is what type of plan would work best for you…
Each type of plan has several important general aspects that may be especially positive or negative for you:
A fee for service plan without a preferred provider feature is a traditional type of insurance in which the health plan will either pay the medical provider directly or reimburse you after you have filed an insurance claim for each covered medical expense. When you need medical attention, you visit the doctor or hospital of your choice. This approach may be more expensive for you and require extra paperwork.
A fee for service plan with a preferred provider option (PPO) allows you to see medical providers who reduce their charges to the plan; you pay less money out-of-pocket when you use a PPO provider. When you visit a PPO, you usually won’t have to file claims or paperwork. However, going to a PPO hospital does not guarantee PPO benefits for all services received within that hospital. Also, the network may not have all the doctors or hospitals you want. If you don’t use the network, you will generally pay more when you get care; fewer preventive health care services may be covered; and you will have to file claims for services yourself.
In “PPO-only” options, you must use PPO providers to get benefits. You will generally pay copayments, but will have no deductibles, and will have little, if any, paperwork.
Health maintenance organization plans charge a copayment for primary physician and specialist visits and generally have no deductible or coinsurance for in-hospital care. More preventive health care services may be covered than under a fee for service plan, and you will have little, if any, paperwork. You will have limitations on the doctors and other providers you can use, however, and care received from a provider not in the plan’s network is not covered unless it’s emergency care or the plan has a reciprocity arrangement.
In HMO plans with a point of service (network) feature, if you use the network, you will get full network benefits and coverage with little paperwork. Such plans let you use providers who are not part of their network but you would pay more and usually pay higher deductibles and coinsurances than you pay with a network provider. Also, some services may not be covered and you will need to file a claim for reimbursement.
In a consumer-driven health plan, you have greater freedom in spending health care dollars up to a designated amount, and you receive full coverage for in-network preventive care. In return, you assume significantly higher cost sharing expenses after you have used up the designated amount. The catastrophic limit is usually higher than those common in other plans.
In a high deductible health plan, the enrollee pays a deductible and other out-of-pocket cost up to certain limits. They can have first dollar coverage (no deductible) for preventive care and higher out-of-pocket copayments and coinsurance for services received from non-network providers.
In addition, consider these personal questions when comparing types of plans, or different plans within a category:
While your exact need for health care is unpredictable, you can act on what you reasonably can foresee. Then examine whether your existing plan is best for such considerations, or whether a change would better fit your needs.
Do you expect to have any medical costs in the coming year that you didn’t have in the current year? For example, are you expecting upcoming surgery? Or can you reasonably expect different types of care or procedures than you currently experience, such as chiropractic care, laser eye surgery or extensive dental work? If you have family members on your plan, don’t forget to think through those same issues regarding them.
What would be your share of the cost of prescription drugs you reasonably expect to be taking? Could your medication needs foreseeably change, and what would be your cost for them?
What deductibles, copays, and coinsurances would you pay under your various options? Can you (if an active employee) make them effectively more affordable by paying for more of them through a health care flexible spending account?
One valuable feature of FEHB and PSHB is that you can change your coverage each year. That is, you could switch plans to capture the benefits of an attractive feature that you may need in only one year—related to the upcoming birth of a child, for example—and then switch back again the following year.
Finally, there are circumstances in which a married couple without eligible children may choose to have two self-only plans. It’s not uncommon for both in a couple to work for the federal government and each have an entitlement to enroll on their own. One attraction of having separate coverage is that it allows each to tailor their plan selection to their specific needs.
However, keep in mind that each enrollee will have to meet the co-insurance and deductible requirements plus the catastrophic limit on his or her own. This may or may not make a difference in the decision. Also, one of the enrollees would have to elect self plus one to obtain coverage for a new child. In that case, it likely would make more sense to switch to one family enrollment.