OPM seeks public input on reshaping FEHB plan options to curb premiums

The Office of Personnel Management (OPM) has issued a request for information (RFI) seeking public input on how to optimize the health benefits plan options offered under the Federal Employees Health Benefits (FEHB) Program, including the Postal Service Health Benefits (PSHB) Program. The notice, published in the Federal Register on September 15, 2026, asks stakeholders whether the current cap of three plan options per carrier should be changed to give enrollees high-value choices at competitive costs while managing premium growth.

The RFI is published under 5 CFR Part 890 (Docket ID OPM–2026–xxxx, RIN 3206–XXXX) and is open for public comment. Meredith Gitangu, Senior Benefits Analyst at OPM, is the contact for the notice.

Background and scope

The FEHB Program was established in 1960 and is the largest employer-sponsored health insurance program in the United States, covering approximately 8.3 million individuals, including federal employees, annuitants, covered family members, former spouses, statutorily eligible groups under 5 U.S.C. 8901, and tribal employees under 25 U.S.C. 1647b. Postal Service employees, annuitants and their families are eligible under the PSHB Program pursuant to 5 U.S.C. 8903c.

Under current rules, health benefits plans are limited to offering three options, or two options plus a high-deductible health plan (HDHP), pursuant to 5 CFR 890.201(b)(3)(i). For Plan Year 2026 the FEHB Program counts 132 plan options from 47 carriers, while the PSHB Program offers 75 plan options from 17 carriers.

Regulatory history

OPM has used rulemaking on plan options before. In 2010 it amended 5 CFR 890.201 to allow eligible FEHB plans to offer three options without requiring one to be a high-deductible health plan, applying to employee organization plans and health maintenance organizations under 5 U.S.C. 8904(3) and (4). In 2018 OPM extended that flexibility so all health benefits plans could offer three options or two options plus an HDHP, covering the Service Benefit Plan and the Indemnity Benefit Plan under 5 U.S.C. 8903(1) and (2).

The current RFI supports the FY 2026–2027 Annual Performance Plan’s Strategic Objective 2.3, which seeks to “establish and apply evidence-based criteria to assess the appropriate number and distribution of health plan options available to enrollees.”

Questions posed to stakeholders

OPM is collecting input on the effect of more, fewer or different plan options on premiums, health care costs, consumer experience and operational practices. Key questions include:

• How might more, fewer or different options lessen cost burdens or mitigate premium increases for enrollees and the government?
• Would a wider variety of options drive enrollees toward lower-premium plans, and how should cost-sharing be communicated?
• Should there be a threshold or upper limit on what a plan may charge for premiums?
• What impact would more HDHPs with health savings accounts have on enrollees and the government?
• What operational and contracting changes would carriers face under different option structures?

Enrollee satisfaction remains high: the 2023 Federal Employee Benefits Survey reported that 90% of respondents considered FEHB availability “extremely important/important,” 94% believed it “meets needs to a great or moderate extent,” yet only 66% rated it an “excellent or good value.”

Why it matters

The outcome of this RFI could reshape the health coverage choices available to millions of federal employees, annuitants and their families, and influence how OPM manages rising health care costs. Any change to the number or type of plan options would affect premiums, the government contribution and the consumer experience across the largest employer-sponsored health insurance program in the country.

Source: Federal Register, Vol. 91, No. 178, September 15, 2026, Notices section (official reference: FR Doc. 2026-18944).