Submitted by Kent Ervin and Doug Unger
On March 19th, the PEPB Board made final decisions on plan design and rates for FY2027, effective 7/1/2026.
Open enrollment is May 1 to May 31. Participants should carefully consider whether to choose different plan options, which have the following major changes:
High-Deductible Health Plan (aka Consumer Driven Health Plan):
- Increase the deductible from $1650/$3300 to $1700/$3400 (single/family)
- Increase the out-of-pocket maximum from $4000/$8000 to $5000/$10000 (single/family)
- No change in employee premiums, which are the lowest of the three plan options, from the current year. For example: $55/month for employee-only and $411/month for a family.
Low-Deductible Health Plan (aka Copay PPO plan)
- Currently no deductible. FY2027 deductible of $300/$600 (single/family)
- Increase the out-of-pocket maximum from $4000/$8000 to $5000/$10000 (single/family)
- Increase employee premiums. For example: increases of $68/month (75%) for employee-only and $159/month (32%) for a family, for new totals of $160/month (employee-only) and $657/month (family).
Exclusive Provider Organization (northern limited-network plan)
- Decrease out-of-pocket maximum from $5000/$10000 to $4000/$8000 (single/family)
- Increase employee premiums. For example: increases of $161/month (73%) for employee-only and $378/month (47%) for a family, for new totals of $361/month (employee-only) and $1,180/month (family).
Health Maintenance Organization (southern limited-network plan)
- No changes to benefits, out-of-pocket maximum remains at $5000/$10000 (single/family)
- Same employee premium increases as northern EPO plan: new totals of $361 for employee-only and $1,180 for families.
A summary rate table for state active employees is below. PEBP has published the full rate tables as approved by the Board on March 19th.
| PEBP State Actives |
FY2026 |
FY2027 |
Premium Change FY27 vs. FY26 ($) |
Premium Change FY27 vs. FY26 (%) |
| Total Rate |
Employer Contrib. |
Employee Premium |
Total Rate |
Employer Contrib. |
Employee Premium |
| High-Deductible Plan (CDHP) |
| Participant |
$849 |
$794 |
$55 |
$820 |
$764 |
$55 |
$0 |
0.0% |
| Participant+Spouse |
$1,684 |
$1,370 |
$314 |
$1,624 |
$1,310 |
$314 |
$0 |
0.0% |
| Participant+Children |
$1,162 |
$1,010 |
$152 |
$1,121 |
$969 |
$152 |
$0 |
0.0% |
| Participant+Family |
$1,996 |
$1,585 |
$411 |
$1,926 |
$1,515 |
$411 |
$0 |
0.0% |
| Low-Deductible Plan (Copay PPO) |
| Participant |
$886 |
$794 |
$92 |
$1,064 |
$904 |
$160 |
$68 |
75% |
| Participant+Spouse |
$1,757 |
$1,370 |
$387 |
$2,113 |
$1,591 |
$521 |
$134 |
35% |
| Participant+Children |
$1,212 |
$1,010 |
$202 |
$1,457 |
$1,162 |
$296 |
$93 |
46% |
| Participant+Family |
$2,083 |
$1,585 |
$498 |
$2,506 |
$1,849 |
$657 |
$159 |
32% |
| EPO/HMO |
| Participant |
$1,014 |
$794 |
$220 |
$1,309 |
$928 |
$381 |
$161 |
73% |
| Participant+Spouse |
$2,013 |
$1,370 |
$943 |
$2,907 |
$1,642 |
$962 |
$319 |
50% |
| Participant+Children |
$1,388 |
$1,010 |
$379 |
$1,795 |
$1,196 |
$599 |
$220 |
58% |
| Participant+Family |
$2,387 |
$1,585 |
$802 |
$3,089 |
$1,909 |
$1,180 |
$378 |
47% |
Success of NFA and State Worker Advocacy
Hundreds of public comments were submitted by state workers opposing the punishing premium increases that were presented to the Board at the February meeting, ranging up to $1104/month (EPO/HMO family tier, total $1905/month) and up to 215% (EPO/HMO employee-only, total $473/month). Strong advocacy from NFA and other state worker organizations held the damage in check, but the impact on employees and families is still bad. Without NFA calling attention to budget and revenue discrepancies over a period of months, the situation could have been much worse.
NFA advocates will continue to monitor the situation at PEBP and follow up on serious issues—budgetary and strategic—that have been raised by this year's unacceptably messy and non-transparent PEBP decision-making process.
