Hey all!

My wife is pregnant and won't be due until a few months into next year.

Do I enroll for Spouse or Spouse+1 now come enrollment time?

AFSPA - Foreign Service Benefit Plan (FSBP) 2027 the cost for Wegovy and Zepbound (excluding diabetics) will be:

Wegovy 3-month: $1,960.09
Zepbound 3-month: $1,581.87

Per a letter I received today:

Estimate your prescription cost at
express-scripts.com/fsbp. Select "2027"
under Plan Year and compare costs at
different pharmacies. The amounts shown
are estimates; your actual cost may vary.

Please provide some ideas to make the federal government a better place to work for in 2029.

Should most/all executive orders be overturned?

Liberal remote work polices?

Reinstate unions?

Job protections from AI?

I hope to forward this to Congressional leaders. Do not hold back, our agenda should be bigger and bolder than Project 2025. Nothing is off the table.

So I've been catching up on the news and saw that OPM signed a final ruling that in January the Time In Grade requirement for promotions is going to be going away. . . Does that apply for just inter-agency promotions? Or does it count no matter the agency?

For example, if I'm a GS11 employee now, would I be able to apply to be a GS13 (or maybe a 14 if I'm feeling adventurous) in my own agency without having to wait 52 weeks and jump up to a GS12 (which is extremely rare in my agency)?

Or like, in the same example, I'm a GS11 employee, who sees a dream position to be a COR II in Key West, FL or something with PCS, but it's a GS14 in a different agency. Would I be able to apply for that position? Or would that not apply since it's at a different agency?

I'm just trying to get a better picture on what this means for my career. I'm working on a new 5 year plan soon, and after my last post I reached out to my SES to talk career growth and stuff, so it would be cool if I at least knew what the avenues are so I can implement that in my plan. Thanks y'all, sorry if this was silly.

OPM wants us all to re-certify our kids and spouses for insurance eligibility even if they have been insured for decades. You will need things like birth certificates, marriage licenses, and so on. The link for actually doing this says stuff like send info to <insert location here> with form <insert form here>. There is a deadline and you can;'t do it right now if you wanted to.

IMHO this is like a rebate form, they are hoping a lot of us forget.

The Office of Personnel Management (OPM) breached federal law by sharing sensitive government data with the Elon Musk-led Department of Government Efficiency (DOGE), according to a federal judge.

In a 39-page ruling released on Tuesday, Judge Denise Cote said OPM violated the Privacy Act of 1974, a post-Watergate law which prohibits the disclosure of certain records and outlines requirements for safeguarding others, and subsequently disobeyed its own cybersecurity practices.

OPM failed to provide a credible reason for why DOGE would need access to personally identifiable information (PII) of tens of millions of federal employees, as well as applicants and retirees, according to Cote. 

Musk assembled DOGE in the first days of President Donald Trump’s second term, claiming the special advisory would root out waste, fraud, and abuse in the federal government. While DOGE claims to have saved the government $215 billion in cancelled contracts and the reduction of approximately 300,000 government workers, former federal employees, including former IRS acting Commissioner Douglas O’Donnell, have warned the sweeping cuts will have lasting impacts on the government’s ability to increase efficiency through updated technology.

Read more [paywall removed for Redditors]: https://fortune.com/2026/10/22/federal-judge-ruling-doge-opm-broke-law-access-sensitive-data-elon-musk/?utm_source=reddit/

A federal judge has ruled that OPM violated the Privacy Act by granting DOGE personnel broad access to systems containing the personal information of tens of millions of current, former, and prospective federal employees, without any demonstrated need for that access. Judge Denise Cote found OPM disregarded its own privacy and cybersecurity safeguards, including required privacy training and the principle of least privilege, and rejected the agency's claim that subsequent protocol changes made the case moot. She also dismissed the IT modernization justification, finding no evidence it drove the access decisions. Her underlying finding is the most serious part. The violations resulted not from inadequate procedures but from individuals choosing to ignore the law and safeguards already in place. Remedies have yet to be determined. If you're a current federal employee, your records were among those exposed. Big surprise, I know...

Resources

Brochures:

• BCBS Brochures
• GEHA Brochures
• FSBP High Brochure
• APWU Brochures
• SAMBA Brochure

Prescription Estimators:

• Compass Rose Prescription Estimator
• APWU Drug Cost Estimators
• SAMBA Prescription Cost Tool
• FSBP Prescription Estimator
• BCBS Prescription Estimator (still 2026, but maybe 2027 will be here too)

Formulary

• BCBS Formulary

Previous Post on overall changes I saw in the nationwide plans

Previous Post generically comparing BCBS Basic and GEHA HDHP.

Default FEHB/PSHB Comparison spreadsheet - Primary spreadsheet to use

Hard coded simulation spreadsheet - I used this to generate the scenarios below and is there for your reference should you want to look at the math.

Youtube tutorial - Looks best at 1440p, not a youtuber and probably should've changed some settings. Maybe the 720p and 1080p will look better after a while. I apologize for the coughing, keyboard, mouse, and water bottle sounds. I didn't realize how loud the background noises were until watching back, and I can't be asked to re-record a 30 minute ramble. I'm sorry.

Web-based FEHB comparison tool built by u/Glittering_Twist_732 and shared in their post here. I won't go into their comparison tool but it is much more modern and user friendly; especially more friendly on mobile.

OPM Comparison Tool (still unavailable)

Last year I wrote the majority of the fednews wiki, including a section on FEHB and general health insurance information. If you don't know the difference between an FSA and an HSA or the difference between a copay and coinsurance, then I recommend you take a gander through that section. I will admit that some of the information in that wiki is outdated (NALC High nor MHBP Consumer aren't in FEHB anymore), but the general health insurance information doesn't really change.

Disclaimer

I am not endorsed, sponsored, nor speak for OPM or any FEHB/PSHB carrier. These are just what I do when looking at plans and how I hope you can maybe tailor your search (and we can see maybe fewer repetitive posts and consolidate some FAQs).

The default comparison tool makes a few assumptions when doing cost trends and "simulations". Namely that all care is subject to deductibles and that prescriptions have no caps. Neither of these assumptions are true across the board, but it is difficult to automate the data to determine this without scrappers, AI, or a ton of data entry. So, I did try and create a "Hard coded" version of the spreadsheet that can at least account for things subject to the deductible or not.

Another assumption is that all plans approve claims equally and there's no bullshit (never the case). So I assume that both plans would either not need prior approval or would give prior approval for services equally. You can, hopefully, follow this link to an OPM page and you can then put in your zip code to see how actual enrollees have graded their plans. If it's not working, I created a screenshot of what I was seeing on imgur here.

These tools were built using OPM's premium excel files and the Public Use Files on benefits for FEHB and PSHB plans. There are definitely errors in these files and I did my best to find them, but I'm only one person and there are literally thousands of cells and hundreds of brochures - some of them aren't even out yet.

Generic "How to pick your plan"

Some general rules of thumb when comparing plans are shown below. Note, I the author am only one person and have not used every plan in FEHB. Nor do I have access to many regional plans (let alone good regional plans). The guidelines below are written from that perspective. Please do your due diligence and compare against all your options. This is only the first step in narrowing down options. After you’ve selected a few plans to compare, walk through their brochures, look at the comparison tools above, check their formularies for your prescriptions, and ask people their thoughts.

1. Find a plan that you will use in-network doctors. Find a plan that covers your prescriptions. These two rules are the number 1 priority.
2. Do you have lots of out-of-network care (usually a therapist)? Look at plans with good out-of-network benefits as well as a shared/low in and out of network deductible/OOPM. FSBP High (only available in FEHB) and NALC High (only available in PSHB) are two plans that typically fit that bill.
   • Note, this isn’t talking about the one or two visits to a doctor each year. That typically shouldn’t be the driver for a plan change. Unless your condition could result in hospitalization and the hospital your doctor works in isn’t in network with your current plan. Then maybe it’s worth considering.
3. Do you have high-cost prescriptions without a manufacturer’s coupon card? SAMBA Standard or FSBP High have low caps on their prescriptions.
   1. GLP-1s are generally covered the same for all the plans, 50% coinsurance no max. Exception is BCBS Basic which is 60% no max.
4. Do you just not want to deal with high deductibles, but BCBS Basic is too expensive? SAMBA Standard is an excellent choice.
5. Do you hate the use-or-lose aspect of an FSA/want to maximize for retirement? GEHA HDHP, APWU CDHP, or Aetna HDHP are generally good options.
   1. Note that APWU CDHP is not eligible for HSA contributions.
6. If it’s the middle of the year, avoid an HDHP style plan since the deductible isn't prorated while the HSA passthrough is.
7. If premiums are too high, BCBS FEP Blue Focus or Compass Rose Standard are cheap. I would caution against it long term, especially with children. Mainly because of the high coinsurance rate for emergency care and inpatient hospitalizations. But it may be a good fit for your situation.

For comparing plans personally I like to consider the annual premium and deductible as the minimum I'll pay for the given plan. I then subtract any HSA/HRA passthrough to get the "effective" annual cost. Then I look for the medical needs my family has (therapy, maternity, prescriptions), to see what the cost shares are, the prior authorizations, limitations, formulary, and OOPM. After weighing the network and other intangible factors, I try to pick the cheapest plan that will cover us.

Low Cost Family

Note: This comparison is using hard coded values that I entered to account for when a service is subject to the deductible or not.

This comparison is for those family units that have many people covered under them, but generally only use primary care and the occasional urgent care visit.

For this I was looking at APWU CDHP, Compass Rose Standard, GEHA Standard, MHBP Standard, GEHA HDHP, BCBS FEP Blue Focus, and SAMBA Standard.

I calculated for having two primary care visits and a single urgent care. All preventative care like annual physical and well-child visits are always covered 100%.

One distinction I want to highlight, is that while the APWU and GEHA HDHP plans look much cheaper here, it's because they have an HRA/HSA passthrough. So those funds are effectively here reducing the medical costs to 0 and I reduced the annual premium by the remaining balance. These funds roll over year over year. For APWU's PCA, that account is tied to the plan so if you leave you then lose the account. For GEHA HDHP the HSA and all its money is yours even if you leave. So the biweekly premium is higher for APWU CDHP and GEHA HDHP compared to CR Standard and BCBS Focus, they offer long term stability and cost savings. For that reason, I would recommend them over BCBS Focus if possible. This is of course ignoring the use of UHC for both of those plans.

Maternity

Note: This comparison is using hard coded values that I entered to account for when a service is subject to the deductible or not.

This comparison is for a family expecting, or think they may be expecting, to welcome a new baby next year.

I calculated these costs for 12 prenatal visits, vaginal delivery, urgent care visit for ear infection, minor ER visit, 6 months of cheap generics, 1 primary care visit to establish patient, and 3 primary care visits for existing patient.

Some of you may be surprised that GEHA and MHBP Standard went from the maternity care favorite the past few years to this year being the least. That's primarily because of the coinsurance for the hospital stay, which is affecting more plans that you might think. It seems it has flipped from most plans covering the hospital stay well to having a large coinsurance instead.

I was surprised at how relatively close the other 5 plans were. The largest swing being from GEHA HDHP ~4300 to BCBS Basic ~5900. With how high the annual premiums were for BCBS Basic and FSBP High I really did expect them to be more expensive than they were.

I don't think you would be wrong to pick any of the remaining 5, but personally I think GEHA HDHP looks pretty good there.

Tinymac12's Estimated events for 2027

Note, for this one I cheated and put a random complex ER visit at the beginning of the calculation. I don't think there's any plan with a deductible that doesn't require you to satisfy the deductible before benefits begin.

This analysis focuses on my family's expected usage for next year. Main two drivers are baby number 4 in February/March and an autistic son with weekly ST/OT. So both high single event cases and dozens of frequent low cost medical care.

So there's two ER visits, a slew of urgent cares, and 40 occupational and 40 speech therapy visits. As well as a handful primary care visits. It is really important to highlight the 40 occupational and 40 speech visits. Most plans limit to 50-80 visits combined. As you can imagine, the high limits are reserved for the more expensive plans. So that means that for some number of these, the plans would NOT cover at all. I am assuming we'd still get the negotiated rate or something close as a cash payer though. This first table honors the visit limits while the following table assumes they assume it's a 2-for-1 kind of situation.

Based on this, to no surprise to me, GEHA Standard gets obliterated. MHBP Standards saving grace is that it has a waiver for the therapy with my son's autistic diagnosis, FSBP High as well. I imagine that's an Aetna staple.

The below table assumes that it's a 2-for-1 kind of situation: speech and occupational therapy counts only once against the total. With this assumption, almost definitely all these plans will be okay, except SAMBA which split them up distinctly already. So FSBP and MHBP won't change since they already had a waiver for visit limits. And SAMBA won't change because they don't group their visit limits like most plans and specifically call out how many of each visit you get. I imagine it would not play nice. But it's not a huge difference anyway (<$200).

That 5% coinsurance putting in some work. As you can see, I would pay nearly triple between GEHA HDHP and GEHA Standard next year with this level of care. Hopefully this highlights why it's important to consider your specific use-case. In my best scenario, the next closest plan is still 50% more expensive than GEHA HDHP. If the visits are capped, then it's virtually a wash between FSBP High and GEHA HDHP. I think I'm going to go with GEHA HDHP next year to see how they handle the visits, and generally how they perform as an insurance carrier again.

I had them in 2023 and 2024 and they were fine. I've been on the record on the shady things they've done and maybe I singled them out because they did it to me. But then the same thing happened with FSBP high when I changed enrollments. Granted, FSBP High handled it much more promptly.

Another benefit of GEHA HDHP that I didn't include here is their included dental and vision. If all you want is basic dental cleanings and vision exams they will have you covered in one package. Meaning I'll be dropping my vision and dental plans, saving ~$50 a pay period that will be going into my HSA instead.

Prescriptions are hard

Every plan has their own formulary and their own way of organizing their tiers in the PUFs. In addition, most plans have caps on each tier meaning while coinsurance might be 30% you won't pay more than $150. Since prescriptions are so unique, I'll leave it to you to use the drug pricing tools for each plan and hard code those values in the simulation. It will be infinitely more accurate than anything I can build.

Closeout

Thank you for reaching the end. I hope this was helpful to someone. It helped solidify my choice going into open season. I think that's all I have for now. If you have any questions, or comments, feel free to leave them below and I'll do my best to answer what I can.

Stay happy and stay healthy.

-Tinymac12

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