2027 FEHB Enrollment Options: Who Counts as a Family Member, When You Can Switch and the Five-Year Rule

Federal employees and retirees enrolled in the Federal Employees Health Benefits (FEHB) program have three enrollment choices: (1) self only; (2) self plus one; and (3) self and family. These enrollment types are explained below.

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Coming Soon! New 2027 FEHB Comparison Tool 

Enter your email here and get an email alert when our free 2027 FEHB Plan Cost Explorer tool is launched before Open Season starts. Nov. 9.  The tool will show every FEHB plan available to you with the 2027 premium, the dollar and percent change from 2026, the annual cost, how much of the premium the government pays, and a worst-case year that adds the out-of-pocket maximum.

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The Three FEHB Enrollment Types

• Self only. Only the employee or retiree is enrolled in an FEHB program health plan, with no eligible family members enrolled.
• Self plus one. An employee or retiree is enrolled in an FEHB program health plan together with one eligible family member. An eligible family member includes a spouse or a child under the age of 26. A child under age 26 can be enrolled on the health plan whether or not the child is eligible to be claimed as a tax dependent.
• Self and family. An employee or retiree is enrolled in an FEHB program health plan together with multiple eligible family members, including a spouse and any number of children who are under the age of 26.

Note that for both the self plus one and self and family enrollment options, a child under age 26 (or a child of any age who is not capable of self-support because of a mental or physical disability that existed before age 18) is also an eligible family member.

Two Key Facts About FEHB Enrollment

Two key facts related to FEHB program enrollment are noted and explained below.

First, an employee or retiree does not have to wait until the annual FEHB program open season to change from self and family coverage to self plus one enrollment. For example, suppose a federal employee or retiree has self and family enrollment in which the insured family members include a spouse and one child aged 25. When the child turns 26 during the calendar year (and is therefore no longer eligible to remain on the plan), the employee or retiree can switch to self plus one enrollment in the middle of the year, with no need to wait for the next open season. That saves on biweekly or monthly premiums once the change is made.

Second, a retiring employee does not have to be enrolled in self plus one for five continuous years to meet the five-year FEHB program requirement for continued enrollment in retirement. The employee needs to be enrolled in the FEHB program for five continuous years, ending on the day of the employee’s effective retirement date. During those five years, the employee’s FEHB enrollment can be self only, self and family, or under a family member’s self plus one enrollment, such as a spouse’s. The employee must retire on an immediate Civil Service Retirement System (CSRS) or Federal Employees Retirement System (FERS) retirement, thereby receiving a CSRS or FERS annuity. The first annuity check is due to be paid one to two months after the employee retires.

Self and Family Can Cost Less Than Self Plus One in 2027

Employees and retirees who are married with no eligible children to include on their FEHB program plan, and single parents with one child to enroll, have the option to enroll as self plus one rather than self and family. By enrolling in self plus one rather than self and family, a married employee or single parent can usually pay less in FEHB program premiums each year.

During 2027, however, there are three national FEHB program health plans (the Foreign Service Benefit Plan, the Panama Canal Area Benefit Plan and the Mail Handlers Benefit Plan) and 37 local FEHB program plans in which the monthly self and family premium is less expensive than the monthly self plus one premium. Federal employees and retirees who want to compare self and family and self plus one premium rates for 2027 can review the Office of Personnel Management (OPM) FEHB premium rates, or use the FEHB premium rates page here. Employees and retirees enrolled in the Postal Service Health Benefits (PSHB) program can compare PSHB premiums on the OPM PSHB premiums page.

There are two possible reasons why self and family monthly premiums are less than self plus one monthly premiums in some FEHB and PSHB program plans.

• The statutory formula used to calculate the federal government’s contribution. The formula is based on the average of all plan premiums and requires that OPM calculate a maximum contribution for each enrollment type. In other words, there is a limit on how much the federal government will contribute toward the cost of a self only, self plus one or self and family enrollment. The federal government contributes the smaller of the maximum contribution or 75 percent of the total premium. The remaining amount is the enrollee’s (employee or retiree) share. In some cases, such as plans with a premium cost above the program average, the calculation may result in a higher enrollee share for self plus one enrollment than for self and family enrollment.

• A disproportionately high enrollment of older and retired couples with no children. Self plus one enrollment was introduced into the FEHB program in 2015. Before then, an employee or retiree with only one eligible family member to enroll was forced into self and family coverage, so the monthly premium cost was actuarially higher. A married couple with no eligible children, or a single parent with one eligible child, was in effect subsidizing enrollees with more than one eligible family member. Self plus one premiums should be lower for those individuals.

Why Some Plans Are an Exception

That has largely proven to be the case over the past eleven years. However, during that time there has also been an anomaly in some FEHB program plans that attract a disproportionately high enrollment of older married couples (particularly retirees) with no eligible children (that is, no children under age 26) on their enrollment. These couples tend to consume more health care, and more expensive health care, than younger employees. For example, the cost of a hip replacement or bypass heart surgery is likely far greater than the cost of giving birth.

OPM has asked agencies to call this to the attention of employees, and OPM is calling it to the attention of married retirees: some FEHB program health plan premium rates for self plus one coverage during 2027 will be more expensive than self and family coverage premium rates. Affected employees and retirees should be sure to check the self plus one and self and family premium rates for their plan. If the 2027 self plus one premium rate exceeds the self and family premium rate for the plan in which they are enrolled, the employee or retiree is advised to change their enrollment.