Health Insurance Premiums Up in 2016: What Will You Pay for Self Plus One Coverage?

By on September 29, 2015 in Pay & Benefits with 561 Comments

A number of readers have been wondering about the self-plus-one health insurance options for federal employees and retirees. The new program begins in 2016, but the open season for those wanting to switch to the new plan is coming up soon. Open season starts on November 9, 2015 and ends on December 14, 2015. (The 2016 federal insurance rates are now online so readers can check out each plan.)

There will also be a limited enrollment period in January 2016 that will allow some people to make the switch to self plus one if they wish to do so. (See OPM Announces New “Limited Enrollment Period” for Self Plus One Enrollment)

How much will rates change under the federal employee health benefits program in 2016? As an overall overage, the Office of Personnel Management (OPM) has announced the average premium increase will be 6.4 percent in 2015. The average increase for participants, however, will be increasing 7.4 percent.

Health insurance premiums in the federal program have increased each year.  There was a 7.3 percent increase in 2011, 3.8 percent in 2012, 3.4 percent in 2013, 3.7 percent in 2014 and 3.2 percent in 2015. In other words, health insurance premiums in 2016 will be going up the most they have increased in the past five years.

The other question in the forefront for many readers is: “How will the self plus one option compare to the more traditional total family plans that have been used for many years?” Those who elect the self plus one option will save money compared to the 2016 premiums for the “self and family” plans. But, realistically, many readers may not save as much as they may have hoped.

For example, below are tables showing 2016 rates for two popular plans under the FEHB. Under the Blue Cross Standard Benefit Plan, an employee will pay $501.17 for the self plus one option in 2016. In 2015, under the self and family plan for Blue Cross Standard coverage, an employee under the FEHB paid $462.17. So, under this plan, those who are enrolling in the self plus one option will pay more in 2016 for self plus one coverage than they did in 2015 for family coverage.

To take another example, in 2016, as noted in the charts below, an employee in the FEHB using the GEHA’s Standard Benefit Plan will pay a monthly premium of $241.25 for the self  plus one option. In 2015, using the GEHA standard health plan, an employee would pay $241.65 for the family plan.

According to the National Association of Active and Retired Federal Employees (NARFE): “On average, switching from Self and Family to Self Plus One will save enrollees about $278 for the year in 2016. However, as compared to their 2015 Self and Family premiums, they will see an average premium increase of about $232 for the year due to the overall increases in premiums. That, of course, is preferable to the $510 average premium increase for Self and Family premiums for the year.”

Here is a rundown on how these plans will compare in price in 2016:

Nationwide Blue Cross and Blue Shield Service Standard Benefit Plan

2015 Bi-Weekly Total Premium 2016 Total Bi-Weekly Premium Employee Pays Change in Employee Payment
Self $293.04 $313.55 $100.18 $9.15
Self and Family $661.88 $726.74 $238.24 $24.93
Self Plus One $692.33 $231.31

 

2015 Monthly Total Premium 2016 Total Monthly Premium Employee Pays Change in Employee Payment
Self $634.92 $679.36 $217.06 $19.83
Self and Family $1434.07 $1574.60 $516.18 $54.01
Self Plus One $1500.05 $501.17

Nationwide Blue Cross and Blue Shield Basic Service Benefit Plan

2015 Bi-Weekly Total Premium 2016 Total Bi-Weekly Premium Employee Pays Change in Employee Payment
Self $253.62 $273.94 $68.48 $5.08
Self and Family $593.86 $652.70 $164.20 $15.74
Self Plus One $621.77 $160.75

 

2015 Monthly Total Premium 2016 Total Monthly Premium Employee Pays Change in Employee Payment
Self $549.51 $593.54 $148.38 $11.00
Self and Family $1286.70 $1414.18 $355.76 $34.09
Self Plus One $1347.17 $348.29

Nationwide GEHA High Benefit Plan

2015 Bi-Weekly Premium 2016 Total Bi-Weekly Premium Employee Pays Change in Employee Payment
Self $296.26 $313.72 $100.35 $6.10
Self and Family $673.80 $745.43 $256.93 $31.70
Self Plus One $690.18 $229.16

 

2015 Monthly Total Premium 2016 Total Monthly Premium Employee Pays Change in Employee Payment
Self $641.90 $679.73 $217.43 $13.22
Self and Family $1459.90 $1615.10 $556.68 $68.68
Self Plus One $1495.39 $496.51

Nationwide GEHA Standard Benefit Plan

2015 Bi-Weekly Premium 2016 Total Bi-Weekly Premium Employee Pays Change in Employee Payment
Self $196.18 $207.16 $51.79 $2.75
Self and Family $446.12 $489.91 $122.48 $10.95
Self Plus One $445.39 $111.35

 

2015 Monthly Total Premium 2016 Total Monthly Premium Employee Pays Change in Employee Payment
Self $425.06 $448.85 $112.21 $5.95
Self and Family $966.59 $1061.47 $265.37 $23.72
Self Plus One $965.01 $241.25

With regard to retired federal employees, NARFE made this observation: “Not only are their health insurance premiums increasing by 7.4 percent, it is unlikely they will receive a cost-of-living adjustment (COLA) to their annuities next year. Additionally, many federal retirees are facing a more than 50 percent increase in their Medicare premiums, further diminishing their ability to make ends meet. In a year in which health insurance costs are increasing substantially, we can clearly see a need for a new formula to calculate COLAs, one that accurately reflects the health care costs of our nation’s seniors.”

Overall, NARFE made this comment regarding the 2016 health insurance premiums for federal employees: ““For the sixth year in a row, the FEHBP premium increase will take a bite out of the already reduced paychecks of federal employees across the country. In the past five years, pay raises for federal employees have totaled a mere 2 percent. The 6.4 percent increase in health insurance premiums is slightly higher than various estimates of private-sector increases, and it could even mean reduced take-home pay for some federal employees, who are slated to receive a 1.3 percent pay raise next year.”

Here are links to obtain all FEHB rates for 2016:

© 2016 Ralph R. Smith. All rights reserved. This article may not be reproduced without express written consent from Ralph R. Smith.

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About the Author

Ralph Smith has several decades of experience working with federal human resources issues. He has written extensively on a full range of human resources topics in books and newsletters and is a co-founder of two companies and several newsletters on federal human resources.

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