More on ‘Self Plus One’

(This article first appeared in the September-October 2015 issue of The American Postal Worker magazine.)

Self Plus One is a new enrollment type that will be offered by the Federal Employees Health Benefits (FEHB) Program beginning in 2016. Self Plus One allows you to cover yourself and one eligible family member you designate.

Starting next year, all FEHB plans will offer Self Only, Self Plus One, and a Self and Family coverage. Postal employees and annuitants will be able to select Self Plus One coverage during the 2015 Open Season, which will run from Nov. 9 to Dec. 14.

Because Self Plus One is new this year, if you’re interested in signing up, you must do so during Open Season. Remember to shop around and compare FEHB plans using comparison tools available at PlanSmartChoice.com and opm.gov/insure.

APWU Health Plan’s website will also have information on Open Season benefits for the High Option and Consumer Driven Option. Visit www.apwuhp.com in October for details.

Below are responses to frequently asked questions.

Will a Self Plus One enrollment cost less than two Self Only enrollments or a Self and Family enrollment? Rates for plans are not yet available. During this year’s Open Season, be sure to look at the rates for your current plan and for other plans as well.

Who can be covered under a Self Plus One enrollment? Self Plus One enrollment covers the enrollee and one designated eligible family member. The definition of eligible family members has not changed. Eligible family members can include a spouse OR a child up to age 26. Children aged 26 or over who are incapable of self-support because of a mental or physical disability that existed before age 26, are also eligible family members.

How is Self Plus One different from Self Only or Self and Family coverage? Self Only covers the enrollee only. Self and Family enrollment covers the enrollee and all eligible family members. The new Self Plus One enrollment covers the enrollee and one eligible family member.

When will OPM release the rates for the Self Plus One enrollment type for each plan? Rates are announced in early October, before Open Season begins. When posted, 2016 rates will be available at www.apwuhp.com or www.opm.gov/openseason.

When will Self Plus One enrollment become effective for annuitants? If you choose Self Plus One coverage during the 2015 Open Season, it will be effective on the Jan. 1, 2016. If you choose Self Plus One coverage outside of Open Season, it will be effective on the first day of the first pay period following the one in which you make a change. For annuitants, Open Season enrollments are always effective on the first day of the year following the end of the Open Season.

If I choose Self Plus One now, will I be able to make changes to my plan later? Yes. You can always change your plan during Open Season. In addition, you can make changes if you experience a Qualifying Life Event (QLE). For example, if you are married and chose a Self Plus One enrollment, in the event you divorce, you can change to Self Only coverage. Alternatively, you can change to Self and Family if you have a child. Other QLEs allow you to make changes as well. See a list of all QLEs at www.opm.gov.

Will domestic partners/non-married partners be eligible for coverage under Self Plus One? No. Only legally married spouses are eligible under any FEHB enrollment, including Self Plus One.

For additional info, visit www.apwuhp.com, www.opm.gov/healthcare-insurance/special-initiatives/self-plus-one/, http://www.opm.gov/healthcare-insurance/healthcare/plan-information/ or consult the Guide to Federal Benefits.