Posted on Thursday, 1st October 2015 by

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OPM announced that the 2016 FEHB premiums will increase an average of 6.4 percent. Enrollees, on average, will pay $5.50 more each pay period for Self Only coverage and those with Self and Family coverage will pay $19.61 more per pay period. OPM also states in their latest press release that, “for over 95% of enrollees, the enrollee share for Self Plus One will be lower than the enrollee share for Self and Family in their current plan. However, it is possible that some plans will have higher enrollee shares for Self Plus One enrollments than for Self and Family enrollments. Therefore, enrollees are encouraged to carefully review their choices before making a change; switching to Self Plus One is voluntary.”

I can understand why the costs for the Self Plus One would be higher than the Self Only option but it is difficult to understand why any plan would charge more for a Self Plus One option over a family enrollment. Look over the plans and costs carefully before making a change.

The new premium rates were released this week and I was personally very disappointed with the Self Plus One rates. There is little difference, a few dollars, from the Family rates for many plans and some plans actually charge more for the Self Plus One! Unbelievable….

The majority of retirees have Blue Cross and Blue Shield plans. My wife and I are enrolled in the nationwide Blue Cross and Blue Shield Basic Service Benefit Plan. In 2016 the Basic Self and Family rates are listed at $355.76 per month compared to $348.29 for the Self Plus One. A total savings of $7.47 cents! The new Self Plus One Blue Cross and Blue Shield Basic rate is $26.62 more than we paid last year monthly for our family plan. The Nationwide NALC Value Option plan offers the Family and Self Plus one options for the exact same price and the nationwide MHBP – Standard plan charges $30.62 more for the Self Plus One plan over their Family Plan.

With little to no COLA coming our way in 2016 and significant Medicare Part B premium increases next year for many, retirees suffer again for another year. Add to this the Federal reserve that has kept interest rates low for 9 years transferring the interest retirees would have made on their savings to the federal government so they can continue to borrow 40% of every dollar they spend! I wrote an article several years ago about the National Debt Crisis that you may find interesting. The Medicare 2016 premium increases coming will be limited under a hold harmless clause to retires that aren’t signed up for Social Security or pay an income adjusted Medicare premium. They will bear the burden of the Obama care fiasco.

With the increased costs and little if any COLA this year it is a good time to review your current health care plans to ensure they cover the services you need at a cost you can afford. The FEHB Open Season runs from November 9 through December 14, just a month or so away.  There are many things to consider including the new Self Plus One option that does offer a little relief starting in 2016 for some plans. For those turning 65 soon, and will be paying a Part B Medicare premium, you may want to consider a lower cost FEHB plan. Another consideration is the services you will need in 2016, evaluate each plan carefully to ensure they cover any special services that you may require.

Even with these disappointments we still have excellent coverage. I’ll be personally reviewing a number of plans with the prospect of changing to a lower cost provider since my wife and I both pay Medicare Part B premiums.

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The information provided may not cover all aspect of unique or special circumstances, federal regulations, medical procedures, and financial information are subject to change. To ensure the accuracy of this information, contact relevant parties and ask them to review your official personnel file and circumstances concerning this issue. Retirees can contact the OPM retirement center. Our article is not intended nor should it be considered investment advice and our articles and replies are time sensitive. Over time, various dynamic economic factors relied upon as a basis for this article may change. The advice and strategies contained herein may not be suitable for your situation and this service is not affiliated with OPM or any federal entity. You should consult with a financial, medical or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Last 5 posts by Dennis Damp


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9 Responses to “FEHB Self Plus One – A Major Disappointment”

  1. Michael Prine Says:

    In preparation for making a health care change in the upcoming “Open Season” from Self & family to Self plus One a relationship code for the spouse is required to complete/update the forms. I can not find that code on any related website. What is the relationship code for spouse???

  2. Doyle Deierick Says:

    Response to Dennis. I just read that in order for your spouse to continue with your federal health insurance after your death, you have to be enrolled in self plus family, for them to continue with the health insurance after your death. Apparently self plus one will not work.

  3. Jim - Self Plus One Rate Concerns Says:

    I wished your article would have also explained the reason for why the plan was developed in the first place and if it met that goal. My assumption (sorry) was it was developed to save the two person family some money compared to the larger families. You didn’t mention that the costs for Self Plus One should be closer to double the Self Only rate. Has someone from OPM reviewed the calculations and can they explain these discrepancies or the logic of why the rates don’t make sense. Is it the assumptions by the actuaries etc. that impact the rates? I guess the Self Plus One plan assumes that the Federal worker is healthy and their spouse or other dependent has serious health problems?

  4. Dennis Damp Says:

    Excellent point and one that I missed for my first review. About a year ago I wrote an article that talked about the Self Plus One plan and estimated the cost savings to be similar to the savings we have had in the dental and eye care programs, a considerable savings. Unfortunately that didn’t happen. Your perspective is interesting, The BCBS rates for Basic Self is $148.38 and the Self Plus One is $348.29. Two Self enrollments would cost $296.76. The Self Plus One rate is $51.53 higher! I intend to interview BCBS later this month to determine why from their perspective the rates would be so much higher and will mention your point in an upcoming article.

    Thanks for taking he time to respond to my question.

  5. Dennis Damp Says:

    The controlling factor is that your spouse must be covered when you retire for health care coverage to continue for the retiree and spouse. Previously, the only way to do that was to enroll in the Family Option since there wasn’t a Self Plus One Option until 2016, next year. Now a spouse can also we covered under the Self Plus One option.

  6. Diana Mercier Says:

    I have been waiting for years for a self plus one plan, only to see that there is a $7. difference from family to self plus one. So I still have to pay the same as a family with 10 people. Where did they come up with these figures, really, this is ridiculous. I am so frustrated. Sorry, thanks for letting me vent.

  7. W. Peters, wife if I die 1st? Says:

    What is the Answer to wife’s enrollment: Should I die 1st what will happen if I enroll in BCBS FEDERAL Self Plus One?

  8. Dennis Damp Says:

    You and your spouse can change to a Self Plus One option in in 2016. A surviving spouse can continue to carry your FEHB coverage after the annuitants death as long as the two of you were enrolled in either the Self and Family or Self Plus One option.

  9. Dennis Damp Says:

    Your spouse will be able to continue in the FEHB program and OPM will automatically change her enrollment to self only upon your death. The change to Self Only should be automatic however I advise anyone in this situation to check with OPM to make sure the plan is changed. There have been instances where the surviving spouse coverage was not automatically changes to self only.