[Big Changes] FEHB & Open Season

Big Changes To FEHB In 2016

The 2015 Open Season for Federal Employees Health Benefits will soon be underway!  From November 9th through December 14th, 2015, Federal employees and retirees can make changes to their FEHB, Vision and Dental coverage for 2016.

The Background

In a typical private sector (outside the government) health insurance offering, they offer the following THREE types of plans:

• Self only
• Self+1 (usually a spouse, but can be any eligible dependent)
• Self+2 or more (also known as Family)

Up until this point, the Federal government’s FEHB plan has only offered TWO types of plans:

• Self only
• Self+Family (self plus one or more dependent)

As you can see, the “middle ground” option seemed to be missing from the equation.

The Federal employee covering themselves and one dependent paid the same rate as the person covering themselves plus two or more dependents!

The BIG Change

The Bipartisan Budget Act of 2013 established another enrollment option for FEHB coverage beginning January 2016. The 2015 Open Season is historic in that for the first time, there are now THREE options for types of plans under FEHB:

• Self only
• Self+1 *NEW*
• Self+Family

As you can see, the FEHB plan options will now be modeled after the more “traditional” plans and they are offering the NEW option of Self+1 coverage.

This coverage is usually for an employee plus a spouse, but can cover any eligible dependent (such as a child).

The Real Question

The real question is: will you pay more, less, or the same in 2016? Naturally, there was some hope that the “middle ground” option of Self+1 would be a significant savings from Family rates…

Remember there’s more to Open Season than just FEHB

Open Season is the time of year that Federal employees and retirees are able to add to, drop, or change your health insurance benefits offered through the Federal government.

Side Note: This is also the time of year during in which current employees (sorry, not you, retirees) can enroll or re-enroll—it’s not automatic—in the Flexible Spending Account (FSAFEDs) program.

A friendly reminder about FSA coverage: be very careful if you are thinking about retiring in the next year! The Flexible Spending Account will only reimburse for allowable expenses that occurred while you’re working. Any expenses that occur after you retire are no longer covered by the FSA program—this is known as “use or lose” upon retirement.

What Happens If I Don’t Want To Change Anything?

If you don’t make any changes, then you are agreeing to keep your coverage the same until next year’s Open Season.

There is an exception here, however: if you experience a Qualifying Life Event (QLE) which includes a birth, death, marriage, divorce, or change in employment status, you may qualify to make a change mid-year within 60 days of the event.

If you don’t have one of those events happen, Open Season is your only chance to make a change to your coverage if you wish to do so!