Federal Employees Health Benefits Program: Available Health Insurance Options

by Sabrina I. Pacifici on December 17, 2013

CRS – Federal Employees Health Benefits Program (FEHBP): Available Health Insurance Options - Annie L. Mach, Analyst in Health Care Financing; Ada S. Cornell, Information Research Specialist. November 13, 2013

“The statute governing the Federal Employees Health Benefits Program (FEHBP) is found in Title 5 of the U.S. Code, Chapter 89. The program is administered by the Office of Personnel Management (OPM), which is statutorily given the authority to contract with qualified carriers offering plans and to prescribe regulations necessary to carry out the statute, among other duties.  The federal government is the largest employer in the United States, and FEHBP is the largest employer-sponsored health insurance program. FEHBP covers about 8.2 million individuals, providing an estimated $47 billion annually in health care benefits. The participation rate among eligible enrollees is about 90% (85% of eligible individuals enroll in FEHBP as the primary policy holder, and another 5% are covered as a family member).  Eligible enrollees include current federal employees, the President, annuitants, and eligible family members. Active Members of Congress and certain congressional staff do not receive health benefits through FEHBP as a benefit of their employment, but may be eligible to enroll in FEHBP in retirement. Newly hired employees have 60 days from their entry on duty date to sign up for an FEHBP plan. Part-time workers are also eligible for coverage, but generally they are required to pay a larger share of premiums than full-time employees.”

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