Ask The Experts: Retirement

By Reg Jones

Self plus one for FEHB?

Bookmark and Share

Q. Why doesn’t the Federal Employees Health Benefits program offer a self-plus-one option for health insurance like the Federal Employees Dental and Vision Insurance Program? The cost should not be the same for one plus a spouse as it is for a whole family. I would rather pay two self-only premiums than that for self plus family. The difference between self only and self plus family is staggering.

A. The FEHB law doesn’t provide for that option, and serious consideration has never been given to changing it.

Tags: , ,

Comments

  1. Rachel Fisher Says:
    January 14th, 2012 at 10:35 pm

    Thank you to Reg and John for addressing this issue!! I’ve been a BCBS FEP participant for 13 years and never understood why they don’t offer the “self plus one” option.
    The answer provided is so dismissive it’s almost offensive. What is this FEHB law which the author cited, and what does that even mean? And can’t laws be changed?? John brings up and excellent point: other federal insurance policies offer self plus one coverage. Heck, other BCBS policies offer self plus one coverage!
    I guess the question is who do I/we contact about getting the law changed? With so many childless couples or single parents with one insurable child, I’m sure there are plenty of us who’d jump on this option were it available.

  2. Matt Burkett Says:
    August 1st, 2012 at 10:56 am

    To Rachel Fisher,

    The law and the reasoning is quite clear on OPM’s website at the following location:

    http://www.opm.gov/faqs/QA.aspx?fid=fd635746-de0a-4dd7-997d-b5706a0fd8d2&pid=bce6f21c-994a-469f-a165-c7f5f7d7610f

    The reasoning they provide is still open for debate on several levels, though.

    OPM states that according to section 8905 of title 5, United States Code, “An employee [or annuitant] may enroll in an approved health benefits plan under section 8903 or 8903(a) of this title either as an individual or for self and family.”

    OPM indicates that law [as written and interpreted by OPM]does not allow a Self Plus One option, and that Congress would need to change the law to permit this type of enrollment plan.

    OPM reasons that a self plus one plan may not result in cost savings but the reasoning is completely absurd. The current administration claims it is dedicated to ensuring that all Americans receive affordable health care coverage, but

    My FEHB self only plan costs $66 biweekly, and a self plus family plan costs $220 biweekly. My wife and I do not have children or other dependants, and my employee contribution to our monthly FEHB insurance costs us $440. If we had two children, six children, eight children, etc. our plan would cost us $440. My wife works in the private industry and does not have affordable or quality health insurance coverage. However, if she did work for the federal government, we would save over $300 per month or $3,600 per year simply by staying on self only plans.

    If we look at the rates for dental and vision plans, which do offer self only, self plus one, and self and family coverages, the premiums for self plus one are exactly double the cost for self only.

    OPM says that it comes down to risk sharing among the “older” two-person groups and the younger members with large families. The flaw in OPMs ridculous reasoning is that it gives no consideration to younger two-person families.

Leave a Reply

PLEASE NOTE! Do not submit ANY questions via the Comments form. Instead, please send your questions directly to fedexperts@federaltimes.com. Questions submitted via the Comments form will NOT be answered!