2023 FEHB Plans With Higher Self Plus One Premiums Than Family Option

Some 2023 FEHB plans have higher premiums for the Self Plus One option than the Self and Family option.

Self Plus One 2023 FEHB plans and premiums are cheaper than Self and Family, right? This is not always the case, and that is true for 2023 as well.

The Office of Personnel Management has provided a list of the 2023 Federal Employees Health Benefits program (FEHB) plans which have higher premiums for the Self Plus One option than the Self and Family option which makes the latter option the more obvious choice for these particular plans, at least in terms of cost. There are 84 plans in total.

Federal employees and retirees who are considering Self Plus One plans next year should pay close attention.

In some cases, the difference between the two premiums varies by as much as 20%. For instance, biweekly employee premium for the Kaiser Permanente – Colorado/High plan code option is $259.76 for Self Plus One but is $208.86 for Self and Family.

Other standouts include Kaiser Permanente – Georgia/High, Kaiser Permanente – Mid-Atlantic States/High, and Kaiser Permanente – Northwest/High.

At the other end, there are plans with variations of only a few cents between the two plans, so in these cases the cost difference wouldn’t impact one’s budget nearly as much.

See the complete list for details.

2023 FEHB Premiums

The 2023 FEHB premiums are rising sharply compared to this year. The average increase for the federal employees’ share of the premiums is 8.7%; the average overall increase is 7.2%. The increases in 2023 will be the highest since 2011.

OPM said that the COVID pandemic is largely responsible for the significant premium increase.

What is Self Plus One?

The Bipartisan Budget Act of 2013 established the Self Plus One option under FEHB. The Self Plus One enrollment type covers the enrollee and one eligible family member you designate to be covered whereas the Self option only covers the individual enrollee and Self and Family enrollment covers the enrollee and all eligible family members.

The covered family member under Self Plus One can be either a spouse or a child up to age 26. A child age 26 or over who is incapable of self-support because of a mental or physical disability that existed before age 26 is also an eligible family member.

Who Can Be Covered Under FEHB Enrollment?

Family members eligible for coverage under your Self and Family enrollment are your spouse (including a valid common law marriage) and children under age 26, including legally adopted children, stepchildren (including children of same-sex domestic partners in certain states), and recognized natural (born out of wedlock) children. Foster children are included if they live with you in a regular parent-child relationship. A child age 26 or over who is incapable of self support because of a mental or physical disability that existed before age 26 is also an eligible family member. Your employing office will look at the child’s relationship to you as the enrollee to determine whether the child is a covered family member.

You cannot cover other relatives, such as your mother, even if they are otherwise considered your dependents.

An employee’s agency makes enrollment eligibility decisions in accordance with the law and regulations. Ask your Human Resources Office for help in deciding whether your circumstances meet the requirements.

Source: OPM

When is Open Season?

This year’s FEHB Open Season will run from Monday, November 14 – Monday, December 12, 2022.

During Open Season, federal employees have the opportunity to enroll, change plans or plan options, change enrollment type, or cancel enrollment for the Federal Employees Health Benefits (FEHB) Program and the Federal Employees Dental and Vision Insurance Program (FEDVIP). It is also the opportunity to re-enroll or newly enroll in the Federal Flexible Spending Account (FSAFEDS) Program.

About the Author

Ian Smith is one of the co-founders of FedSmith.com. He has over 20 years of combined experience in media and government services, having worked at two government contracting firms and an online news and web development company prior to his current role at FedSmith.