WASHINGTON, December 27, 2013 — After a bipartisan deal struck by Congress, federal employees will soon have the option for a new type of health insurance plan that allows them to select any one other eligible family member to join them for coverage, in a program formally dubbed “Self Plus One.”
Typically, previous plans either allowed for a federal employee to choose coverage on an individual basis or on a family basis, with nothing in-between.
This marks the first time the Self Plus One option has been available in the Federal Employees Health Benefits Program (FEHBP). For years, the Office of Personnel Management (OPM) claimed that a Self Plus One option was not financially feasible, and refused to offer it. The deal in Congress however requires OPM to do so.
According to OPM’s website, the FEDVIP program previously allowed the option for Dental and Vision benefits, and described it as follows:
“Self Plus One: A Self Plus One enrollment covers you as the enrolled employee or annuitant plus one eligible family member whom you specify. You may choose a Self Plus One enrollment even though you have additional eligible family members, but the additional family members will not be covered under FEDVIP.”
It is unclear how the new plan under FEHBP will function, or what rules will be implemented in relationship to it.
A report from the Congressional Research Service explains what FEHBP is and its history:
“The general model of FEHBP has not changed since its inception in 1959. FEHBP was and is a program that allows competing private insurers to offer numerous types of coverage to enrollees within broad federal guidelines.
“The federal government and the employee/annuitant have always shared the cost of the premium, and generally, employees and annuitants have always had access to the same plans at the same cost. However, specific features of FEHBP have been modified, in some cases multiple times, by Congress and OPM.
“For example, eligibility has been expanded to include additional types of federal employees and dependents, the formula for determining the government’s share of premiums has changed, and the types of health benefits offered through FEHBP plans have been broadened.”
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