November 10 was the start of the Office of Personnel Management (OPM)-sponsored benefits “open season” in which federal employees and retirees (annuitants) make decisions regarding which health insurance, dental insurance and vision insurance plans they want to enroll in during the upcoming 2026 plan year. The open season continues through the close of business on December 8, 2025.
This column discusses choices that employees and annuitants make with respect to their health insurance benefits offered through the Federal Employees Health Benefits (FEHB) program. These choices include joining the FEHB program, adding eligible family members to their FEHB program enrollment, and changing FEHB program health plans. Also presented is a checklist for federal employees who intend to retire during 2026 in order to keep FEHB program health insurance for themselves and eligible family members during retirement.
The FEHB Program and Who is Eligible to Enroll
The FEHB program is the largest employer-sponsored group health insurance program in the world, covering eight million federal employees and retirees, eligible family members of federal employees and retirees, and surviving spousal annuitants. Permanent federal employees (full-time and part-time) can immediately join the FEHB program when they are first hired into federal service.
Three types of enrollments are available in the FEHB program. These enrollments are: (1) Self only; (2) Self plus one (eligible family member), and (3) Self and family (more than one eligible family member). Eligible family members include a current spouse and children under the age of 26. A child includes a biological child, a stepchild, a married child (but not the married child’s spouse or their children), an adopted child and a foster child (provided there is a parent-child relationship, and the employee or retiree is the child’s primary source of financial support and lives with the child).
FEHB Premiums
In terms of cost, each FEHB program health plan has its own premium costs. The federal government pays on average 72 to 75 percent of a full-time employee’s, an annuitant’s or a survivor annuitant’s FEHB premium with the employee, annuitant or spousal survivor annuitant paying the other 25 to 28 percent of the premiums. Employees have their premiums deducted bi-weekly from their bi-weekly before-taxed gross salary, while annuitants and spousal survivor annuitants have their premiums deducted monthly from their after-taxed monthly annuities. It makes no difference which type of FEHB program plan (fee-for-service, PPO, HMO high deductible health plan, consumer driven health plan) an employee, annuitant or spousal annuitant is enrolled in, or the type of coverage (self, self plus one, or self and family) – the percentages of the premium that the employee/annuitant/survivor annuitant and the federal government pays is set by law. SEE: 2026 FEHB Premium Increases
For 2026, there are 47 carriers and 132 plan options in the FEHB program. These include fee-for-service (FFS) plans available to all employees, while other FFS plans are available to specific categories of employee. There are preferred provider organizations (PPO) and health maintenance organizations (HMOs) available in most areas of the US. An employee or annuitant must live or work within a defined area to be eligible to enroll in a particular HMO. There are HMO plans that combine the features of a PPO and HMO called Point-of-Service (POS) plans.
There are also high-deductible health plans (HDHP) that are associated with a health savings account (HSA). HDHPs allow employees to save in order to pay for current and future out-of-pocket medical expenses.
Another type of health insurance plan offered through the FEHB program is a consumer driven health plan (CDHP). A CDHP provides an enrollee with the freedom of spending health care dollars the way the enrollee chooses. The typical plan has common features including enrollee responsibility for certain up-front medical costs, a federal government-funded account that the enrollee may use to pay these up-front costs and catastrophic coverage with a high deductible. The enrollee and covered family members receive full coverage for in-network preventive care. Employees and annuitants can obtain FEHB health plan information for 2026 by going here.
SEE: 2026 FEHB Plan Comparison Tools
In choosing a health plan for 2026, employees and annuitants are encouraged to select a health plan that best meets the medical needs of themselves and, if applicable, covered family members. Looking for a health plan that has the lowest premium cost is not necessarily the best strategy. No health plan pays 100 percent for an individual’s health care expenses. Each type of FEHB program health plan has a deductible, co-payment or coinsurance associated with it. There are preferential ways to pay for these out-of-pocket costs which will be discussed in upcoming MFR columns.
Enrollment and Making Changes in the FEHB Program During Current Open Season
During open season, employees who are not currently enrolled in the FEHB program and who are eligible to enroll may enroll. Current FEHB program enrollees – employees, annuitants and survivor annuitants – may change their FEHB healthplans, type of enrollment and change “premium conversion” status (employees only). SEE: 2025 FEHB Open Season Options
Annuitants who not enrolled in the FEHB program are not permitted to enroll in the FEHB during an open season unless the annuitant had suspended their FEHB enrollment for one of three reasons:
(1) To enroll in TriCare (group health insurance program covering retired members of the Uniformed Services);
(2) To enroll in a private Medicare Advantage (Medicare Part C) plan; or
(3) Because of eligibility under Medicaid or a similar state-sponsored program of medical assistance for the needy.
The effective dates of this year’s open season enrollments and changes in enrollment are as follows:
• A new FEHB enrollment is effective the first day of the first pay period of the 2026 leave year. For most federal agencies, this will be January 11, 2026. That follows a pay period during any part the employee was in pay status.
• A change in FEHB enrollment (for example, from self only to self plus one or from self only to be included as part of another family’s FEHB program enrollment) is effective the first day of the first pay period of the 2026 leave year. For most federal agencies, this will be January 11, 2026.
• For an annuitant or survivor annuitant, a change in enrollment will be effective January 1, 2026.
For information about how to make enrollment changes including changing FEHB health plans, employees, annuitants and survivor annuitants should go here.
Open Season Reminders for Federal Employees Who Intend to Retire During 2026
For those federal employees who plan to retire from federal service sometime during 2026 and who want to retain their FEHB program coverage during retirement (and for eligible family members), the following are three reminders:
1. A retiring employee must have been continuously enrolled in the FEHB program (enrolled under either himself or herself, or under an eligible family member such as a spouse who is also a federal employee) for all of the employee’s last five years of federal service, ending on the effective date of the employee’s retirement. SEE: Rules for Keeping FEHB In Retirement.
2. In order for a retiring employee to make sure that a surviving spouse (not a federal employee) and other eligible family members keep their FEHB enrollment when the annuitant dies, the retiring employee must elect to give his or her spouse a spousal (CSRS or FERS) survivor annuity. The retiring employee has to designate his or her spouse as a survivor annuitant on the application form for retirement (CSRS: Form SF 2808; FERS: Form SF 3107).
3. The surviving spouse who is designated for a spousal survivor annuity be enrolled in the FEHB program at the time of the annuitant’s death. Even if the retiring employee has elected to give a survivor annuity to his or her spouse but the spouse is not included on the annuitant’s FEHB enrollment at the time of the annuitant’s death, the surviving spouse will not be eligible to enroll in the FEHB program. To avoid this from happening, the retiring employee needs to add his or her spouse to the employee’s FEHB enrollment, which should be done in the current open season if the employee intends to retire sometime during 2026.