Walt Francis: Now (and later) is the time for a self-plus-one switch

Premiums, benefits and just where and when retirees can make changes to their health plans were a few of the subjects discussed during a Feb. 10 online chat with federal benefits expert Walt Francis and Federal News Radio’s Mike Causey.

The two answered questions on the Office of Personnel Management’s ongoing limited enrollment period, which runs through Feb. 29.

The enrollment period allows federal employees and annuitants the opportunity to enroll in a self-plus-one option, even if they made a different choice during Open Season last year.

Self-plus-one covers an enrollee and one eligible family member. In September, OPM estimated that about 33 percent of the active federal employees with self or family coverage would shift to self-plus-one, while about 80 percent of the retirees would partake in the new insurance choice.

While the the limited enrollment period will expire for current employees, Francis said it’s important to remember that annuitants can make changes to their plans any time during the year.

“So if you miss the Feb. 29 deadline, don’t worry; just do it in March,” he said.

Annuitants can access retirement services here and OPM contact information here.

Francis also clarified that while the coverage might change, “the benefits do not change.”

“They are exactly the same in self-plus-one as in family,” Francis said. “The plan provider network does not change, it is the same for both. All you need to focus on is the premium difference.”

In most cases, people will see a lower premium under the self-plus-one option, though there are exceptions.

Francis also noted that because self-plus-one coverage works the same way as family coverage in each plan, “if you are in one of the plans that gives you a Medicare wraparound, that wraparound will work exactly the same if you change from family to self-plus-one.”

OPM provided the following list of guidelines for the limited enrollment period:

  • Only for active employees enrolled in self-and-family (must be paying for premiums pre-tax).
  • Decreases in enrollment to self-plus-one are the only allowable enrollment changes.
  • No changes in plans, no option changes, no increases or other decreases in enrollment are allowed.
  • All enrollment changes will be prospective to the first day of the first pay period following the one in which the change is requested.

For annuitants:

  • The limited enrollment period does not apply to annuitants because they are allowed to decrease enrollment at any time. This means that if you have a self-and-family enrollment and you decide you would like to change to a self-plus-one enrollment, you may do so throughout the year.
  • If you have a self-only enrollment, however, you must experience a qualifying life event in order to change to self-plus-one outside of Open Season.

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