Federal Employees Health Benefits Reform Act
Official title: To amend the Federal employee health benefit provisions of title 5, United States Code, to increase the Government contribution rate, to extend coverage for em… Show full official titleShow less
Official title: To amend the Federal employee health benefit provisions of title 5, United States Code, to increase the Government contribution rate, to extend coverage for employees who are separated due to reductions in force, to require carriers to obtain reinsurance or stop-loss insurance (or to otherwise demonstrate financial responsibility), to assure adequate mental health benefit levels and otherwise limit benefit reductions, and for other purposes.
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Executive Comment Requested from OMB and OPM.
Federal Employees Health Benefits Reform Act - Increases the amount of the Government's contribution for an employee enrolled in an employee health benefits plan from 60 to 75 percent of the average subscription charge for such plan. Increases the maximum Government contribution for an enrollee from 75 to 100 percent of such subscription charge.
Requires payment of a Government differential equal to five percent of the average subscription charge, in addition to the Government's contribution, for any enrollee who is over 65 years of age and not entitled to Medicare benefits. Excludes such differential in determining the amount to be paid by the enrollee.
Permits certain persons to elect to continue coverage under a Federal employees' health benefits plan for a specified period. Requires such persons who elect to continue coverage to pay into the Employees Health Benefits Fund an amount equal to the sum of employee and agency contributions paid for the same level of benefits.
Allows annuitants whose annuity is less than the amount required to be withheld for enrollment in a health benefits plan to pay the amount of any deficiency required for enrollment.
Requires contracts for employee organization plans to require carriers to: (1) enter into an agreement approved by the Office of Personnel Management (OPM) with an underwriting subcontractor licensed to issue group health insurance in all States and the District of Columbia; and (2) meet minimum financial standards prescribed by OPM.
Requires the service benefit plan and the indemnity benefit plan to provide, in addition to all currently authorized benefits: (1) nervous and mental disorder benefits; (2) alcoholism and substance abuse treatment and rehabilitation benefits; and (3) comprehensive dental benefits.
Prohibits the OPM from entering into a contract with a carrier for any health benefits plan which does not provide 95 percent of the benefits that such plan or the most similar plan provided during the preceding year, unless the carrier and the OPM mutually agree to waive such requirement.
Prohibits the OPM from entering into a contract for a health benefits plan which excludes anyone because of nonactive employee status.
- Introduced in House Formatted Text
Cite this page
U.S. Congress. (2026). H.R. 216: Federal Employees Health Benefits Reform Act. 101st Congress. Open America. https://openamerica.io/bill/101-HR-216/
"H.R. 216: Federal Employees Health Benefits Reform Act." 101st Congress, 2026, Open America, https://openamerica.io/bill/101-HR-216/.
H.R. 216, 101st Cong. (2026), https://openamerica.io/bill/101-HR-216/.
[H.R. 216: Federal Employees Health Benefits Reform Act](https://openamerica.io/bill/101-HR-216/)