FEHB & PSHB Open Season – Higher Premiums Heading Our Way!

Over the past three years our health care premiums have increased an average of 29.9%! If this trend continues, many will be seeking lower cost coverage among the FEHB/PSHB providers.

The 2025 Open Season runs from November 10, 2025, through December 8, 2025. Federal and Postal employees are able to evaluate their health, dental or vision insurance coverage for the upcoming year.

OPM sent a FEHB Program Carrier Letter to all FEHB and PSHB providers on January 15, 2025. This letter outlines the policy goals and initiatives for the 2026 Programs. An addendum letter was issued on January 31, 2025, to incorporate two Presidential Executive orders designed to address gender ideology extremism and protect children from chemical and surgical mutilation.

This year, OPM is issuing two separate Technical Guidance documents, one for FEHB Carriers and one for PSHB Carriers.

OPM GOALS

As excerpted from their guidance letter, “OPM’s goal for both the FEHB and PSHB Programs is to provide quality, affordable, and equitable health benefits for Federal and Postal Service employees, Federal and Postal Service annuitants, their family members, and other eligible persons and groups.”

The addendum further states, “Pursuant to the first EO, all federal agencies are tasked with ensuring all federal policies and documents that require an individual’s sex list two options, male and female, and shall not make available third options or request gender identity.”

OPM no longer requires Plan Year 2026 proposals to clarify or update the obesity management benefit to include the elements listed in the bullets starting on the bottom of page 10 and continuing through the bottom of page 12 of Carrier Letter 2025-01.

PREMIUM IMPACT

The average increase for our FEHB plans in 2025 was 13.5%, and the PSHB increase was 11.5%, the largest increase in recent memory! This significant rise was due to factors such as rising healthcare provider costs, additional requirements by the previous administration to provide gender affirming care, utilization of prescription drugs, and higher spending on behavioral health services.

The carriers will face challenges again this year due to inflation, rising healthcare costs, and increased drug prices. However, eliminating specific expensive elective procedures and limiting obesity coverage could help moderate any pending increases.

EVALUATE YOUR CURRENT FEHB PLAN

Open season is coming up fast, and it’s a good time to review your current plan’s coverage and ask yourself if it met your needs and expectations this year. Ask these questions:

Did I have coverage issues?
What additional coverage will I need next year?
Was I able to get the medications/prescriptions needed?
Did I have to pay high prescription copayments?
Were my deductibles, copayments, and coinsurance excessive this year?
Are the labs, doctors’ offices, hospitals, and outpatient facilities available in my immediate area and covered by my current FEHB/PSHB plan?
Did I have to travel out of my area to see a provider or have procedures performed?
Was customer service helpful and easily accessible?
Did I encounter unanticipated expenses that I thought were covered by my current plan?
Are you signing up for Medicare this or next year? If so, you may want to consider moving to a lower-cost FEHB plan.
Explore Medicare signup options.

Answering these and other questions will help you prepare for the upcoming open season. If you had problems this year, look for plans that will better suit your needs in 2026.

Helpful Retirement Planning Tools

Disclaimer: The information provided may not cover all aspects of unique or special circumstances. Federal regulations, medical procedures, investment information, and benefit details are subject to change. To ensure the accuracy of this information, contact relevant parties for assistance, including OPM’s retirement center. Over time, various dynamic economic factors relied upon as a basis for this article may change.

The information contained herein may not be suitable for your situation. This service is not affiliated with OPM or any federal entity. You should consult a financial, medical, or human resource professional where appropriate. Neither the publisher nor the author shall be liable for any loss or other commercial damages, including but not limited to special, incidental, consequential, or other damages.

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Dennis Damp

Dennis V. Damp is an author, retired federal manager, business owner, career counselor and veteran. Damp is the author of 28 books, a recognized benefits expert, and a retired federal manager with 35 years’ service. Dennis has been a guest on hundreds of radio talk shows, CNN’s YOUR MONEY and the Lou Dobbs Cable TV shows, lectured at universities and colleges, produced Internet web sites and training videos, and has written hundreds of articles for national magazines and newspapers. His books have been featured in the Wall Street Journal, Washington Post, New York Times and U.S. News & World Report.

Dennis joined the Air Force in 1968 and spent over three years on active duty and an additional seven years with the Air National Guard. He was hired by the Department of Defense (DOD) after leaving active duty and transferred to the Federal Aviation Administration (FAA) in 1975. He spent the remainder of his career in various positions with the FAA. His last position was technical operations manager at the Pittsburgh International Airport’s air traffic control tower.