The Office of Personnel Management told Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits carriers to prioritize prevention, physical and mental wellness, and non‑pharmaceutical treatments in plan year 2027, and requested monthly claims reporting that may include identifiable data.
In its Plan Year 2027 Carrier Call Letter, OPM instructed insurers to expand access to non‑drug interventions and digital therapeutics, promote cost‑effective sites of care, and cut low‑value services. The agency gave the example of requiring other interventions before covering GLP‑1 pharmaceuticals for obesity. OPM also said FEHB will cover all “recommended” vaccines but will place renewed emphasis on informed decision‑making about vaccine risks. The letter states OPM is “expanding its vision for benefits with a stronger emphasis on the physical and mental wellness of the whole person” and endorses “individual autonomy, precision medicine and patient‑centered care.”
The guidance follows sharp premium increases in 2026: OPM cited average spikes of 12.3% for FEHB participants and 11.3% for Postal Service Health Benefits participants. The Call Letter arrived several weeks later than usual, leaving carriers with less than two months to align benefits and set premium rates for 2027.
Separately, OPM published a notice in December seeking monthly submissions of “service use and cost data” from FEHB and PSHB insurers, including medical and pharmacy claims, encounter data and provider data. The notice does not require insurers to remove identifying information from those reports.
Federal employee groups and privacy experts questioned the proposal. “OPM has provided no meaningful explanation for why it needs identifiable data rather than the de‑identified claims data that would serve any legitimate cost‑management purpose,” said the American Federation of Government Employees (AFGE). “It has offered no information about how the data would be protected or how it would be used. That silence is not reassuring.”
Industry observers expect the Call Letter to nudge carriers toward more non‑drug options but say it may not produce wholesale coverage changes. “Combined the letter reflects a trend toward alternative treatments and expanding and encouraging the treatment of underlying causes rather than symptoms,” said John Hatton, staff vice president for policy and programs at the National Active and Retired Federal Employees Association (NARFE).
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Tags: FEHB, digital therapeutics, GLP-1 drugs, claims data, vaccination policy
Topics: Mental wellness & meditation, Mental health technology