It’s that time of year again. You know, the time you anxiously anticipate annually. Yes, it’s Open Season for federal employee health benefits “FEHB,” dental and vision coverage “FEDVIP,” and the Flexible Spending Account “FSA.” Starting November 11 and running through December 9, you’ll have the opportunity to enroll in, cancel or change your current FEHB, FEDVIP and enroll in FSA if you’re still employed.
Realistically, you may not be all that excited about looking at your insurance options. Who is? It can feel overwhelming to think about comparing plans.
Each year, only about 5% of federal employees and retirees change health plans. This can leave you thinking you’re already in the best plan for you and your family.
With the average premium increase for 2025 being 13.5%(!), that may be enough to get you to at least consider reviewing your options. Keep in mind that not all plans increase by the same amount. Some will increase by more and some by less with the average premium increase coming out at that 13.5%. At a minimum, you’ll want to look at your current plan to see how it’s affected.
The overall premium is typically divided up between the federal government’s share, ~72% of the premium, and the employee/retiree share, ~28%. This is true whether you are working or retired. After your pension, your FEHB and FEDVIP are the second best benefits you receive as a federal employee/retiree.
FEHB Premium Increases Under Blue Cross Blue Shield Since 2019
Historically, Blue Cross Blue Shield “BCBS” has been the most utilized plan for the 8.3 million federal employees, retirees and their family members covered by FEHB. Looking at premiums over the last 7 years for the three BCBS plans shows how dramatic the increases have been. Although in some years, the increases were nominal – only ~2% increase in 2022 – over time those increases compound.
| BCBS | Enrollment Type | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | Total Increase | Gov’t Pays |
| Basic | Self | $159.74 | $164.55 | $170.31 | $173.73 | $187.78 | $207.44 | $247.26 | 54.79% | 72.5% |
| Self + 1 | $369.56 | $386.99 | $409.87 | $424.95 | $472.12 | $517.03 | $593.97 | 60.72% | 70.33% | |
| Self + Family | $384.02 | $414.31 | $436.08 | $459.96 | $515.48 | $568.96 | $657.82 | 71.30% | 70.17% | |
| Standard | Self | $243.17 | $253.30 | $267.48 | $276.19 | $308.53 | $326.71 | $378.76 | 55.76% | 63.03% |
| Self + 1 | $555.83 | $578.83 | $608.43 | $627.49 | $690.84 | $729.82 | $832.31 | 49.74% | 62.85% | |
| Self + Family | $581.13 | $621.27 | $650.26 | $680.57 | $753.77 | $803.14 | $920.07 | 58.32% | 62.71% | |
| FEP Blue | Self | $115.15 | $115.15 | $115.15 | $115.15 | $117.46 | $119.83 | $128.21 | 11.34% | 75% |
| Self + 1 | $247.55 | $247.55 | $247.55 | $247.55 | $252.51 | $257.58 | $275.63 | 11.34% | 75% | |
| Self + Family | $272.29 | $272.29 | $272.29 | $272.29 | $277.75 | $283.32 | $303.17 | 11.34% | 75% |
You can see the wide range of increases from a cumulative low of 11.34% in FEP Blue to as much as 71.3% in Basic for Self+Family. Divide that 71% increase by 7 years and it comes out to about 10% a year!
Again, you might not have noticed the increase in 2022, but looking at your share of the premium going from $384 in 2019 to $657 in 2025 (Basic Self+Family) may get your attention.
Going back to the chart, you’ll notice that in the BCBS Standard plan, the federal government isn’t paying that 72% share of the premium mentioned above. They’re only paying about 63%. What’s up with that?
It turns out that there is a maximum amount the government is responsible for under each coverage option (Self, Self+1, Self+Family). For Self, the most the government will pay is $645.84, so if 72% of the total premium is calculated at more than that amount, guess who pays the difference? That would be you!
The total BCBS Standard premium for Self is $1,024.60. 72% of that is $737.71, but because the cap on the government’s contribution is $645.84, that’s all the government contributes. The difference between $737.71-$645.84 = $91.87 is added to your 28% share. Your goal may be to have a plan that meets your specific needs at the lowest cost. You want the government paying as much of the premium as possible.
Your federal health benefits are valuable, and depending on your health and the health of any family members you’re covering, the cost may not be the only factor you consider, but it certainly should be one of the factors. You want to know your costs and what you’re receiving in exchange.
Tips for Comparing FEHB Plans
One of the reasons so few participants change health plans each year is the feeling that you’re not a healthcare expert (not many are), and you don’t even know where to start. Then you pull up the 150+ page outline of coverage and get thoroughly confused. You also don’t want to make a mistake and end up costing yourself thousands of dollars. Here are some pointers in how to approach comparing your current plan with another option.
Pick one of the four “C’s” that’s most important to you:
- Coverage
- Cost
- Choice
- Convenience
Start there. If you’re healthy and don’t go to the doctor often, maybe just get an annual exam, you might choose cost as your first focus. If you’ve been diagnosed with a chronic condition, coverage may be most important to you.
Once you’ve determined what you’re going to compare in the plans you’re considering, there are a couple of great tools you can use to assist you. guidetohealthplans.org is a 3rd party resource that enters the outline of coverage for every federal health plan each year. For a small subscription fee ($15.95), you can access their website to compare any set of plans. Some agencies pay for their employees to use it, so check first to see if it’s available directly through your agency. If not, you can use the code GUIDE20 to receive a 20% discount.
OPM also provides an online comparison tool. I find it more challenging to use because the output is a 17-column spreadsheet.
When considering the risk in comparing plans, look at the maximum out-of-pocket expense you would incur in the worst-case scenario. This is your maximum risk, because even if you’re diagnosed with a rare, expensive condition early in the year, the most you would be on the hook for is that maximum out-of-pocket limit. During the following year’s Open Season, you could simply switch to another health plan that more closely matches your condition.
You have an advantage when it comes to comparing plans. You know what you’ve already been diagnosed with and what specialists you prefer. The insurance company can’t ask! You can change health plans every year if you choose, and no one is ever going to ask you about your health! This allows you to pair an appropriate health plan for your situation…if you’re willing to do a bit of legwork.
