FEHB 2027: what’s already decided — and what you’re still waiting on
Most people don’t think about FEHB until the premiums drop in the fall. But a surprising amount of plan year 2027 is already locked: OPM issued its binding call letter back in March, and every plan you’ll be able to choose in November has already been built to those rules. Here’s what’s settled, what genuinely isn’t, and the retiree-specific traps worth handling now rather than during a two-week scramble.
1. Why the call letter matters more than you’d think
Each spring OPM sends carriers a call letter — the policy requirements they must satisfy when designing benefits and pricing plans for the coming year. It isn’t advisory. Carriers that don’t comply risk their contract, which means every plan on your Open Season menu has already been filtered through it. If OPM requires something, all plans carry it. If OPM prohibits something, none do.
That’s why the call letter is the earliest reliable read on next year: it tells you what the coverage will look like months before anyone publishes a price.
2. The 2027 timeline
3. What’s already locked in for 2027
OPM’s stated theme for the year is “well care” — a broader emphasis on prevention and on physical and mental wellness of the whole person. Underneath that headline sit several concrete requirements.
| Area | What changes in 2027 |
|---|---|
| Anti-obesity medications | Carriers must use intensive behavioral therapy (IBT) both before and during coverage of anti-obesity drugs |
| Gender-affirming care | Coverage ends entirely on January 1, 2027, including for enrollees who were mid-treatment and permitted to continue through 2026; counseling from licensed mental health providers remains covered |
| Vaccines | All ACIP-recommended vaccines still covered at no additional cost; carriers must remove monetary incentives tied to pediatric vaccination |
| Price transparency | Carriers encouraged to educate members on prescription price transparency initiatives |
| Cost containment | OPM directs carriers to exhaust efficiency options before passing increases to enrollees |
4. What genuinely isn’t settled yet
Three things you cannot know until fall: the premiums, which plans are leaving, and which new plans are joining. That last pair matters more than people expect — for 2026 the program shed 14 plans, including a nationwide carrier, NALC, discontinuing both of its FEHB options.
Enrollees in the discontinued NALC plans who took no action were auto-enrolled into GEHA High — a plan that may or may not have suited them. If your carrier terminates, you should receive notice, but the default outcome is someone else choosing for you.
5. Model a premium increase
Rates aren’t out, but the last two years give you a planning range. See what another increase does to your budget.
Your premium
For reference: 13.5% for 2025, 12.3% for 2026. Enter your enrollee share, not the total premium.
Illustrative. Actual 2027 rates vary widely by plan — some rise far more than average and a few decline, which is exactly why comparing plans beats auto-renewing.
6. The retiree-specific traps
Retirement is not a qualifying life event. It does not open a window to change plans — Open Season is your opportunity, same as active employees. After you retire, OPM administers your enrollment instead of your agency, so keeping your contact details current with OPM is what ensures plan notices actually reach you.
Two more: annuitants are not eligible for FSAFEDS flexible spending accounts, though FEDVIP dental and vision remain available. And if you’re approaching or past 65, the FEHB decision cannot be made in isolation from Medicare — the Part B interaction, and any premium giveback your plan offers, can swing the math more than the premium itself.
7. What to do before November
Only about 5% of federal employees switch plans in any given year, even though everyone may. After two straight double-digit increases, staying put by default is an expensive habit. Pull your current premium and out-of-pocket totals now, while you can still think about it calmly, and you’ll be ready to compare in minutes when the rates land instead of guessing in December.
8. FAQ
When will 2027 FEHB premiums be announced?
In fall 2026. OPM issued its call letter on March 31, 2026, carriers submitted benefit and rate proposals by May 31, and negotiations were expected to conclude around mid-August. Final plan offerings and premium rates are then published in the fall, ahead of Open Season, which runs from roughly mid-November through the first week of December 2026 for coverage beginning January 1, 2027. Until those rates are released, any specific premium figure for 2027 is speculation — but the benefit rules carriers must follow are already set.
What is the OPM call letter and why does it matter?
The call letter is OPM’s annual guidance to FEHB and PSHB carriers, setting the policy requirements they must meet when designing benefits and submitting rates for the coming plan year. It is not optional. Every plan you will be able to choose during Open Season has already been filtered through these requirements, and carriers that do not comply risk their contract with OPM. That is why the call letter is the earliest reliable signal of what will change: it tells you what coverage rules are locked in months before anyone publishes a premium.
What changes are already locked in for 2027?
Several. OPM’s stated theme for 2027 is ‘well care,’ with a stronger emphasis on prevention and whole-person physical and mental wellness. Carriers must use a rigorous obesity management approach called intensive behavioral therapy both before and during coverage of anti-obesity medications. Coverage for gender-affirming care ends entirely on January 1, 2027, including for enrollees who were mid-treatment and had been permitted to continue during 2026, though counseling from licensed mental health providers remains covered. Carriers must continue covering all ACIP-recommended vaccines at no additional cost, but must remove monetary incentives tied to pediatric vaccination.
Will premiums go up again in 2027?
No one can say for certain until rates are published in the fall, but the recent trend has been steep. The average enrollee share rose about 12.3% for 2026, following a 13.5% increase for 2025 — two consecutive years of double-digit increases. In the 2027 call letter OPM directed carriers to exhaust cost-containment options before passing increases on to enrollees, which signals awareness of the problem but is not a guarantee of a smaller increase. Prudent planning assumes another meaningful rise and treats a small one as a pleasant surprise.
What happens if I do nothing during Open Season?
Your existing enrollment generally continues automatically into the new plan year, but your benefits and premiums may change substantially. The exception is if your plan leaves the program or reduces its service area — in that case you must choose a new plan, and if you do not, you may be automatically enrolled in a replacement that does not fit your needs. That happened in 2026, when enrollees in the discontinued NALC plans were defaulted into GEHA High. Doing nothing is a decision, and in a year of large premium changes it is often an expensive one.
Can I change plans in retirement, and is retiring a qualifying life event?
Retirees can change FEHB plans during Open Season exactly like active employees, and after retirement OPM rather than your former agency administers your enrollment. Importantly, retirement itself is not a qualifying life event, so it does not create a special opportunity to switch plans outside Open Season. Annuitants are also not eligible for flexible spending accounts through FSAFEDS, though they remain eligible for FEDVIP dental and vision coverage. Keep your contact information current with OPM so plan notices actually reach you.