SelectHealth, Inc., Standard Option: 2027 FEHB premiums and benefits
| Enrollment | Employee, biweekly | Employee, monthly | Annuitant, monthly | Change in your share vs 2026 | Employee, per year (26 periods) |
|---|---|---|---|---|---|
| Self Only code SF4 | $111.80 gov $335.39 | $242.23 | $242.23 | +$5.33 biweekly | $2,907 |
| Self Plus One code SF6 | $245.95 gov $737.87 | $532.90 | $532.90 | +$11.71 biweekly | $6,395 |
| Self and Family code SF5 | $279.50 gov $838.49 | $605.58 | $605.58 | $-7.21 biweekly | $7,267 |
Traditional, HMO/POS network. Offered in Utah (statewide). The county list is on the comparison page. The government share is the lesser of 72% of the program-wide average premium or 75% of this plan's premium (5 U.S.C. 8906).
Educational information only; StandWatch is not acting for OPM, and the brochure and your agency's benefits office are the final authority. Same code and assumptions as the comparison page: worst year is exact (premiums plus the in-network out-of-pocket maximum, minus an HSA deposit); the other three are estimates under stated usage profiles, each labeled copays only, has coinsurance, or not priced.
Deductibles and limits
| Self Only | Self Plus One | Self and Family | |
|---|---|---|---|
| Deductible | $250 out of network $5,000 | $500 out of network $10,000 | $500 out of network $10,000 |
| Out-of-pocket maximum | $7,500 out of network $10,000 | $15,000 out of network $20,000 | $15,000 out of network $20,000 |
What you pay for care, in and out of network
| Service | In network | Out of network |
|---|---|---|
| VISITS | ||
| Preventive care | Member Pays Nothing | Member Pays All Charges |
| Primary care visit | $15 Copayment | 30% Coinsurance after deductible, plus difference between billed and allowed |
| Specialist visit | $35 Copayment | 30% Coinsurance after deductible, plus difference between billed and allowed |
| Urgent care | $35 Copayment | 30% Coinsurance after deductible, plus difference between billed and allowed |
| Emergency room | $250 Copayment after deductible | $250 Copayment after deductible |
| Labs and X-rays | Member Pays Nothing | 30% Coinsurance after deductible, plus difference between billed and allowed |
| CT, MRI, PET | 15% Coinsurance after deductible | 30% Coinsurance after deductible, plus difference between billed and allowed |
| Hospital stay, per admission | 15% Coinsurance after deductible | 30% Coinsurance after deductible, plus difference between billed and allowed |
| Hospital room | 15% Coinsurance after deductible | 30% Coinsurance after deductible, plus difference between billed and allowed |
| Surgeon, inpatient | 15% Coinsurance after deductible | 30% Coinsurance after deductible, plus difference between billed and allowed |
| Outpatient surgery | 15% Coinsurance after deductible | 30% Coinsurance after deductible, plus difference between billed and allowed |
| Mental health, office | $15 Copayment | 30% Coinsurance after deductible, plus the difference between the billed and allowed |
| Mental health, inpatient | 15% Coinsurance after deductible; preauthorization required | 30% Coinsurance after deductible, plus the difference between the billed and allowed; preauthorization required |
| Physical therapy | $35 Copayment preauthorization required after 20 visits | 30% Coinsurance after deductible, plus the difference between the billed and allowed |
| Chiropractic | $35 Copayment 20 visit limit, annually | 30% Coinsurance after deductible, plus the difference between the billed and allowed |
| Acupuncture | Member Pays All Charges | Member Pays All Charges |
| Maternity care | Member Pays Nothing | 30% Coinsurance after deductible, plus the difference between the billed and allowed |
| Maternity hospital stay | $500 Copayment per admission | 30% Coinsurance after deductible, plus the difference between the billed and allowed |
| Infertility diagnosis and treatment | 50% Coinsurance after deductible; preauthorization required | Member Pays All Charges |
| IVF and assisted reproduction | 50% Coinsurance after deductible; preauthorization required | Member Pays All Charges |
| Hearing aids | Covered up to $2,500 every 5 years | Covered up to $2,500 every 5 years |
| Durable medical equipment | 15% Coinsurance after deductible; preauthorization may be required | 30% Coinsurance after deductible, plus the difference between the billed and allowed |
| Home health | 15% Coinsurance after deductible; preauthorization required | 30% Coinsurance after deductible, plus the difference between the billed and allowed |
| Adult dental exams | Not Covered | Not Covered |
| Children's dental exams | Not Covered | Not Covered |
| Routine eye exam | Covered no member cost share | Not Covered |
| Eyeglasses | Covered One pair of eyeglassess or contact lenses to correct an impairment directly caused by accident ocular injury or intraocular surgery (such as for cataracts) | Not Covered |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | $5 Copayment | Not applicable |
| Tier 2 | $100 Copayment | Not applicable |
| Tier 3 | 50% Coinsurance | Not applicable |
| Tier 4 | 30% Coinsurance | Not applicable |
| Mail order | Yes | Yes |
| Prescription out-of-pocket maximum, Self | $7,500 | Not listed |
| Prescription out-of-pocket maximum, family | $15,000 | Not listed |
| WITH MEDICARE | ||
OPM's summary of the plan's cost sharing. The small print under a figure is OPM's own wording and usually carries the real terms: per-day charges, caps, and whether the deductible applies. The brochure is the official statement of benefits.
Official pages
SelectHealth, Inc. plan site · Summary of Benefits and Coverage · OPM plan comparison and brochure RI 73-865 · 844-345-FEHB (3342)
Before you enroll
Not the official statement of benefits. This plan's brochure is the only contractual statement of what it covers, excludes, and limits. Where this page and the brochure disagree, the brochure governs. Read it before you enroll.
Estimates, under published assumptions. Premiums, deductibles, and out-of-pocket maximums are OPM's figures. The year-cost figures are estimates under the usage profiles and assumed charges published on the comparison page, labeled exact, copays only, has coinsurance, or not priced. They are not predictions of what you will spend.
What the model leaves out. Out-of-network care and balance billing, whether your own doctors take this plan, whether your medications are on its formulary and at which tier, referral and prior-authorization rules, mail-order and specialty pharmacy pricing, FEDVIP dental and vision, and Medicare coordination at 65 beyond the rows shown. Postal Service employees and annuitants are in a separate program and are not covered.
No affiliation. StandWatch is not affiliated with, endorsed by, or acting for the Office of Personnel Management or any federal agency. The plan data is OPM's; the arrangement is ours. StandWatch is not a health plan, a broker, or an insurer, and nothing here is a recommendation to select, keep, or drop any plan, or medical, insurance, financial, tax, or legal advice. The full educational-purpose statement.
Source: OPM FEHB Public Use Files, plan year 2027 (rates, plan key, plan benefits, service area), and the OPM premium charts for the change from 2026.
