For years, many have been asking for Self Plus One enrollment categories for FEHB plans. Now, for the 2016 open season, they have arrived. However, many will be disappointed that they will not represent huge savings from Self and Family enrollments–or any savings at all.

The 2016 premiums have been set. By OPM rule, Self Plus One premiums are capped at the Self and Family premium level. This rule makes sense, especially considering that Self Plus One enrollment is optional, as someone covering just one dependent can remain in Self and Family should he/she choose. However, you may have noticed that for some plans, the employee share of the premium is higher for Self Plus One than for Self And Family. How can that be?

It has to do with the way the government contribution is calculated. Under FEHB rules, the government contribution is capped at the lesser of 72% of the weighted average premium for each enrollment category or 75% of the individual plan’s contribution. For 2016, the biweekly contribution caps are:

  • Self: $213.37
  • Self Plus One: $461.02
  • Self And Family: $488.50

This means that for “expensive” plans (those more expensive than average), Self Plus One could cost an employee up to $27.48 more per pay period than Self and Family enrollments.

Questions? Please write to [email protected]!

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