Last Updated: August 12, 2026 Reading Time: 8 min

Ask ten federal employees how much the government pays toward FEHB and nine will say "72 percent of the premium." That answer costs people real money every Open Season, because the 72% applies to a program-wide average, not to your plan. Pick an expensive plan and the government's share is capped in dollars while your share grows without limit.

The Formula Nobody Reads

The government contribution comes from 5 U.S.C. § 8906, and it has two moving parts:

  1. 72% of the weighted average premium across all FEHB plans, weighted by enrollment. For 2026 the biweekly weighted averages are $451.05 (Self Only), $987.73 (Self Plus One), and $1,080.60 (Self and Family). Seventy-two percent of those figures gives the government maximums: $324.76, $711.17, and $778.03.
  2. 75% of your specific plan's premium. This is a ceiling that only binds on cheaper plans.

The government pays whichever number is smaller. That single word is where the "72% of my premium" myth dies.

Below the Cap vs. Above the Cap

A cheap plan (below the cap). GEHA Standard Self Only costs $346.99 biweekly in 2026. Seventy-five percent of that is $260.24, which is less than the $324.76 cap, so that's what the government pays. Your share: $86.75. FEP Blue Focus is cheaper still at $267.24, and the government covers $200.43 of it, leaving you $66.81.

Notice what happened: on cheap plans, the government pays 75%, not 72%.

An expensive plan (above the cap). Blue Cross Blue Shield Standard Self Only costs $513.08 biweekly. Seventy-five percent would be $384.81, but that exceeds the cap, so the government pays the flat $324.76. Your share is $188.32, which means the government is covering 63.3% of your plan, not 72%.

GEHA High ($520.05) works out to a 62.5% government share. In the most extreme documented 2026 case, a high-cost regional plan (Aetna Open Access High in New Jersey), the government share falls to roughly 27%.

The break point for Self Only sits near $432.35 biweekly. Below it, every plan gets 75% covered. Above it, the government's dollars freeze and yours don't.

What This Means at the Margin

Here's the part that should drive your Open Season math. Once you're above the cap, every additional dollar of premium is 100% yours.

Moving from GEHA Standard to BCBS Standard raises the total premium by $166.09 biweekly, but the government contribution rises by only $64.52 (from $260.24 to the $324.76 cap). You absorb $101.57 of the difference per pay period, about $2,641 a year. The richer plan may still be worth it if you use the benefits, but the price tag on the upgrade is much steeper than the sticker premiums suggest.

This is why comparing plans by total premium misleads. Compare employee shares, then compare expected out-of-pocket costs. Our FEHB Calculator shows the government contribution and your actual share for each plan, and its total-cost estimator adds deductibles and copays on top.

The Postal Difference

Postal employees moved to PSHB in 2025, and the same statutory formula runs on a separate, postal-only weighted average. Because PSHB's average is lower ($423.11 Self Only in 2026), the government cap is lower too: $304.64 per period versus $324.76 in FEHB. At the cap, that's a $20.12 biweekly difference, about $523 a year, for postal workers in expensive plans. The Self Plus One and Family PSHB weighted averages are $913.19 and $989.30.

The Retiree Wrinkle: Same Formula, Worse Net Cost

Annuitants get the identical government contribution. What they lose is premium conversion: active employees pay their share pre-tax under Section 125, which for a BCBS Standard Self Only enrollee ($188.32 per period) saves roughly $1,452 a year at a 22% marginal rate once payroll taxes are counted. Retiree premiums come out of the annuity after tax.

So the same plan genuinely costs more in retirement even though the premium never changed. If you're comparing plans in your last working years, run the after-tax numbers both ways.

Check Your Plan's Real Government Share

Use our free FEHB Calculator to see the government contribution and your actual biweekly share for 2026 plans side by side, including regional options by ZIP code. Try it now →

Frequently Asked Questions

Does the government pay 72% of my FEHB premium?

No. It pays the lesser of 72% of the program-wide weighted average or 75% of your plan's premium. Cheap plans get 75% covered; expensive plans hit a fixed dollar cap and you pay everything above it.

What is the maximum government contribution for 2026?

Per biweekly pay period: $324.76 Self Only, $711.17 Self Plus One, $778.03 Self and Family.

Where does the cap kick in?

For Self Only, at a total plan premium of about $432.35 biweekly in 2026. Below that, the government pays 75% of the premium; above it, the flat cap applies.

Is the PSHB formula different for postal employees?

The formula is the same but runs on a lower postal-only weighted average, so the caps are lower: $304.64 for Self Only in 2026, about $523 a year less than FEHB at the cap.

Do retirees pay more for the same plan?

Effectively yes. The government contribution is identical, but retirees pay their share after tax while active employees pay pre-tax through premium conversion, which is worth several hundred to over a thousand dollars a year depending on bracket.

Sources: 5 U.S.C. § 8906 · OPM cost-of-insurance reference · OPM 2026 FEHB premium rates · OPM PSHB premium tables · NARFE 2026 premium analysis