More than 30,000 federal insurance enrollees may be in for some sticker shock next year, if they choose to do nothing during Open Season.
With eight plan options being discontinued in the Federal Employees Health Benefits (FEHB) program, participants currently enrolled with those carriers — most of whom are enrolled in plans from the National Association of Letter Carriers — will, in some cases, face more than a 200% spike in premium costs, if they accept the auto-enrollment plan option for 2026.
Typically, participants whose plans leave the FEHB program are automatically enrolled in the lowest-cost nationwide plan the following year. But for 2026, the Office of Personnel Management chose a different path forward.
The specifics behind OPM’s decision remain unclear, but an OPM spokesperson told Federal News Network the agency chose a plan that’s not the lowest-cost nationwide plan “because we determined it was in the best interest of the program to do so.”
“The default plan designation ensures enrollees who do not choose a plan during Open Season continue to have health insurance coverage, but OPM strongly encourages enrollees in terminating plans or plan options to review the plans available to them for 2026 and choose the one that best meets their needs,” the spokesperson said.
Under federal regulations, FEHB participants whose plans are discontinued — and who do not take action during Open Season — will be automatically enrolled in the lowest-cost nationwide plan that is not a high-deductible health plan (HDHP), and that does not include membership fees. But the regulations additionally state, “OPM reserves the right to designate an alternate plan for automatic enrollments if OPM determines circumstances dictate this.”
For 2026, the lowest cost nationwide plan that fits the statutory requirements is GEHA Elevate. But OPM made the decision to “exercise its authority” to make GEHA High the auto-enrollment plan instead.
A spokesperson for GEHA declined to comment for this story.
All enrollees have the opportunity to make a different plan selection during Open Season, if they choose to. Open Season began Nov. 10 and will run until Dec. 8, for changes that will take effect starting in January. More information on FEHB premium rates is available on OPM’s website and in carriers’ plan brochures. Participants can also use OPM’s plan comparison tool to weigh various options for 2026.
Comparing FEHB premiums, benefits
In total, eight plan options across six plans are leaving FEHB in 2026, which will impact roughly 32,000 participants. The vast majority of affected participants were enrolled in a health plan from the National Association of Letter Carriers. NALC had two plans — NALC High and NALC CDHP (Consumer Driven Health Plan) — in the FEHB marketplace. Neither will be available in FEHB for plan year 2026, although NALC will remain a carrier in the Postal Service Health Benefits (PSHB) program.
Between those two plans, about 29,000 total participants were enrolled in NALC for 2025. Nearly 26,700 were enrolled in NALC High. A smaller portion, just over 2,300 FEHB participants, were enrolled in NALC CDHP.
Regardless of which NALC plan they were in, all of those enrollees will have to either pick a new plan during Open Season, or be auto-enrolled by OPM. NALC did not immediately respond to a request for comment.
Outside of the two NALC options that will account for the vast majority of impacted enrollees, others from various smaller plans leaving FEHB will also be automatically enrolled in GEHA High, if they do not select a different plan during Open Season this fall.
The other plans leaving the FEHB program in 2026 are:
- Health Alliance’s HMO Standard
- AvMed Health Plan’s HDHP and Standard plans
- Independent Health’s High plan
- Blue Care Network of Michigan’s High plan
- Priority Health’s High plan
In terms of premiums, the exact cost increase depends on a participant’s plan option.
For instance, an enrollee in the “self and family” plan option of NALC High has been paying $283.94 per biweekly pay period for their insurance in 2025. If that enrollee takes no action, and gets auto-enrolled in the “self and family” plan for GEHA High next year, the biweekly cost will increase to $525.18, beginning in January 2026 — an increase of nearly 85% in premium cost to the enrollee.
In a more striking example, an enrollee in the “self and family” plan option of NALC CDHP, who has been paying $146.26 per biweekly pay period this year, will see their premium cost surge by nearly 260% next year — paying a premium of $525.18 per biweekly pay period, if they are auto-enrolled into GEHA High.
By comparison, the average premium increase across all FEHB plans for 2026 is 12.3%, when taking into account the 47 carriers offering a total of 132 total plan options for next year. Not all plan options are available to all FEHB enrollees, as some are specific to certain agencies or geographic regions.
Premium costs, however, are far from the only factor that enrollees should be considering when making a plan selection, according to federal health plan experts.
“FEHB enrollees losing their NALC health plan should carefully consider which health plan will be the best fit for them,” said Kevin Moss, director of marketing and fundraising at Consumers’ Checkbook. “Besides reviewing the plan premium and out-of-pocket costs for benefits, make sure to check the website of the new plan you’re considering to see if your current providers will be in-network, and how any prescription drugs you may take will be covered.”
Notably, the lowest-cost nationwide plan, GEHA Elevate, has lower premiums, but also much lower coverage than GEHA High. NALC High — which the vast majority of those impacted by OPM’s decision are coming from — is more similar to GEHA High than it is to GEHA Elevate, but still with some differences in benefits.
For instance, an enrollee in NALC High who had a $300 deductible for a “self only” plan in 2025 would move to a $500 deductible in 2026 under GEHA High. By comparison, the enrollee’s deductible would increase to $750 under GEHA Elevate.
As another example, an enrollee in NALC High with a catastrophic out-of-pocket maximum of $3,500 for a “self only” plan would see that limit increase to $7,500 under GEHA High. The out-of-pocket maximum for GEHA Elevate, in contrast, is $10,600.
John Hatton, senior vice president of policy and programs at the National Active and Retired Federal Employees Association (NARFE), said a higher-premium plan with more coverage may be the best plan for some enrollees, but not necessarily others.
“Maybe the high premium plan with more coverage is the right choice for you, but you may want to look at some other alternative plans that might be cheaper. Because there are options, even with really low deductible plans, that have lower premiums than the main big dogs in the program,” Hatton said in a recent interview on The Federal Drive. “So it’s really critical that you look and choose what’s best for you.”
If you would like to contact this reporter about recent changes in the federal government, please email [email protected] or reach out on Signal at drewfriedman.11
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