November 28, 2014
The Federal Employees Health Benefits (FEHB) Program: 2014
The 2015 Plan Year
The Federal Employees Health Benefits (FEHB) Program is
the largest employer-sponsored health benefits program in
the United States. FEHB is administered by the Office of
Personnel Management (OPM). Participation in FEHB is
voluntary, with 85% of federal employees enrolled and
90% of federal retirees participating. In FY2013, FEHB
provided about $44 billion in health benefits.
According to the most recent estimate from OPM for 2014,
there are about 4 million policyholders in FEHB, covering
about 8.2 million people, including federal employees,
retirees, and their eligible family members. This number
includes employees and retirees of the United States Postal
Service (USPS). See Figure 1 for a breakdown of FEHB
Figure 1. Profile of FEHB Policyholders, 2014
The 2015 plan year runs from January 1, 2015, through
December 31, 2015. For 2015, there are 257 plan options.
FEHB enrollees choose a health plan from a health
insurance carrier participating in FEHB. Each carrier offers
one or more plans. Generally, FEHB health insurance
carriers and their health plans fall into two broad categories:
fee-for-service (FFS) plans or health maintenance
organizations (HMOs). FFS plans are generally available
nationwide, and HMOs tend to be locally available. Details
for all FEHB plans are available on OPM’s website at
As a practical matter, depending on where an enrollee
resides, the choices are limited to about 15 different plans.
Plan choices change each year, as plans enter or leave the
program or change geographic service areas. For 2015,
there are four new local health plans entering FEHB and
five local plans leaving FEHB.
Other program options available during open season are the
Federal Employees Dental and Vision Insurance Program
(FEDVIP) and Federal Flexible Spending Account Program
(FSAFEDS). All individuals eligible for FEHB, including
retirees, are also eligible to enroll in FEDVIP, which
provides supplemental dental and vision insurance.
Currently, FEDVIP has more than 1.4 million enrollees in
dental plans and more than 1 million in vision plans. Active
federal employees are eligible for FSAFEDS, which allows
employees to pay for health care expenses with pretax
dollars. More than 332,000 federal employees participate in
Source: Congressional Research Service (CRS) analysis of Office of
Personnel Management (OPM) data.
The 2014 open season for the 2015 plan year runs from
November 10, 2014, through December 8, 2014.
Individuals can enroll for the first time or change their
existing health insurance plan during the annual open
season. Outside of open season, changes are only allowed
for individuals with a qualifying life event, such as
For employees (other than USPS employees) and retirees in
2015, the weighted average enrollee share of the biweekly
FEHB premium for both self and family is $136.86 and the
average government contribution is $317.49, for a total
average biweekly premium of $454.35. Figure 2 compares
these figures with previous years.
Total premiums for employees (other than USPS
employees) and retirees will rise by an average of 3.2% in
2015, a smaller increase than the 3.7% increase in 2014.
Although premiums increased on average by 3.2%,
premiums for any given plan may have increased by more
or less or declined. However, looking only at premium
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The Federal Employees Health Benefits (FEHB) Program: 2014 Open Season
changes may not give a complete picture of year-to-year
plan changes, as plans may modify benefits or cost-sharing.
For comparisons with other years, see Figure 3.
Figure 2. Weighted Average Biweekly FEHB
Premiums for Employees (Non-USPS) and Retirees,
than the Basic plan and a deductible, but it has lower copays and greater choice of providers, including coverage for
non-preferred and non-participating providers as well as
preferred providers. The Basic plan has a lower premium
and no deductible but higher co-pays, and it only covers
preferred providers. Selected plan details for the Standard
and Basic BCBS plans are listed in Table 1.
Table 1. Table 1. Employee (Non-USPS) and Retiree
Premium Contributions and Cost-Sharing , Standard
and Basic BCBS Plans, 2015
Figure 3. Average FEHB Premium Increase per Year,
Enrollee share of biweekly
$213.31 (family) $148.46 (family)
Calendar year deductible
Co-payment for preferred
primary care provider office
visit/Preferred specialist office
deductible does $25/$35
not apply for
Coinsurance for participating 35% of plan
35% of plan
except in special
Source: Blue Cross Blue Shield (BCBS) Benefit Plan, 2015.
Source: CRS analysis of OPM data, except for the 2015 increase.
That increase was announced in the OPM press release, “OPM
Announces 2015 Federal Employees Health Benefits Program
Premium Rates” (October 7, 2014).
For employees (other than USPS employees) and retirees,
the government share of premiums is set in statute at 72%
of the weighted average premium of all plans in the
program, not to exceed 75% of any given plan’s premium.
For USPS employees, the USPS contribution to premiums
is collectively bargained.
For more information about FEHB, see CRS Report
RS21974, Federal Employees Health Benefits Program
(FEHBP): Available Health Insurance Options and CRS
Report R42741, Laws Affecting the Federal Employees
Health Benefits Program (FEHBP). Also of interest may be
CRS Report R43194, Health Benefits for Members of
Congress and Certain Congressional Staff.
Ada S. Cornell, firstname.lastname@example.org, 7-3742
Kirstin B. Blom, email@example.com, 7-2397
Plan Details: Blue Cross and Blue Shield
The most popular insurance carrier in FEHB is Blue Cross
and Blue Shield (BCBS), which offers two FFS health
plans: a Standard health plan and a Basic health plan. These
plans have the highest level of FEHB enrollment, with a
total of more than 2.5 million (more than half) of FEHB
policyholders. The Standard plan has a higher premium
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