The Office of Personnel Management (OPM) has taken two significant steps to enhance the collection and storage of health care claims data for the Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) Programs. This summary explains how these changes are connected, their potential impact on you and your family, and when they may take effect. The purpose of this article is to update readers on some of the underlying changes in the FEHB program.

The Initial Proposal: Collecting More Detailed Claims Data

In December 2025, OPM published a proposed information collection request under the Paperwork Reduction Act that would require FEHB and PSHB carriers to submit detailed claims and cost data.

Instead of just summaries, this means sharing manufacturer rebate information associated with prescription drugs. OPM’s goal is to sharpen its oversight: uncovering what drives costs, comparing plan performance, negotiating better deals, catching fraud or waste, and keeping coverage affordable for more than 8 million federal employees, retirees, family members, and postal participants. 

This is a request to collect information under the Paperwork Reduction Act, not a change to your benefits or plan rules. The public comment period wrapped up in early 2026, and as of mid-2026, the request is still waiting for the green light from the Office of Management and Budget (OMB). There’s no official launch date for the new data feeds yet.

The Recent Update: Refreshing the System That Will Hold the Data

In June 2026, OPM rolled out a Privacy Act System of Records Notice to refresh and relaunch its existing database. The system’s name is shifting from “OPM/Central-15, Health Claims Data Warehouse Records” to “OPM/Central-15, Health Benefits Claims and Cost Records.” This update introduces three important changes:

• Includes PSHB records in addition to FEHB records
• Adds new data fields, such as specific drug codes, pharmacy rebates, coordination-of-benefits details, and dates of service, to support detailed claims analysis as outlined in the earlier proposal
• Updates the permitted uses and sharing of data (routine uses), and describes privacy safeguards such as pseudonymization, which replaces most personal identifiers with codes or null values for analytical purposes

Although they were published six months apart, the two notices are closely related. The first would require insurers to submit far more detailed claims information. The second updates OPM’s system for storing, analyzing, and protecting that information once it is received.

Impact on Federal Employees and the Workforce

For most federal employees, retirees, and family members in FEHB or PSHB, daily processes will remain unchanged. You will continue to use your current plans, visit your usual providers, and file claims as before. 

Any new reporting to OPM will be managed by the carriers, not by you as a user of the FEHB. The primary changes involve privacy measures and program management:

• OPM will soon have access to more detailed information about the care you and your family receive. OPM states that this data will be used solely for oversight, cost analysis, negotiations, and fraud prevention, and that most data will be coded to protect your identity. OPM will receive significantly more detailed claims information than it previously collected, although most day-to-day analysis is intended to use coded rather than directly identifiable records.
• More comprehensive data may enable OPM to negotiate lower premiums or design more efficient benefits in the future, potentially helping to control rising out-of-pocket costs.
• However, there are concerns about data security, particularly given OPM’s history of breaches. Additional concerns remain regarding the sensitivity of medical information and the potential for broader data sharing in the future.

No changes to eligibility, covered benefits, or how you enroll are part of these notices. Any future shifts in plan design or premiums would come through the regular annual FEHB negotiation and Open Season process.

Timing: What’s Already in Effect and What’s Next

Most revisions to the System of Records became effective upon publication on June 23, 2026. The revised routine uses became effective on July 23, 2026, after the public comment period closed.

The expanded monthly claims data collection from carriers is still contingent on approval by the Office of Management and Budget (OMB) of the December 2025 information-collection request. If approved, OPM will announce the implementation timeline separately. Because OMB has not yet approved the expanded reporting requirement, the timing of implementation remains uncertain.

These two initiatives reflect OPM’s efforts to use more detailed claims data for improved cost control and oversight. The upgraded storage system is operational, but expanded data collection from insurers is still pending final approval and a launch date. Federal employees do not need to take any action at this time but should monitor OPM’s website or the Federal Register for updates.

Is There a Reason for Concern that OPM Can Identify FEHB Users?

OPM’s updated claims system works in two layers:

• A restricted operational side retains actual identifying details, such as names, Social Security numbers, and full member IDs. Only a small number of authorized staff access this side to verify data quality and link individual claims over time.
• A separate analysis side replaces most personal details with codes, a process known as “pseudonymization.” Names and Social Security numbers are removed, birthdates are limited to the year, and addresses are reduced to ZIP codes. Most staff only access this coded version.

Because OPM could match codes to individuals when necessary, the data are not fully anonymous. The Federal Register notice notes that the agency retains the ability to reconnect coded records to identifiable individuals when this is authorized; it has the technical capability to review an individual’s claims history for purposes permitted under the Privacy Act, such as oversight, audits, fraud investigations, or data validation. 

Several commenters responding to the Paperwork Reduction Act notice questioned whether collecting identifiable claims information was necessary and raised concerns about cybersecurity and potential secondary uses of the data.

OPM states that access to identifiable information will be limited to authorized personnel and authorized purposes under the Privacy Act.

Bottom Line

OPM’s updated records system now permits it to store and analyze more detailed health claims information than before. Although routine analysis is intended to rely on coded records, OPM retains the ability to reconnect those records to identifiable individuals specifically for authorized purposes. This is probably not a problem but is mentioned in order to be as clear and accurate as possible. 

The expanded reporting requirement for insurance carriers has not yet taken effect because it still requires OMB approval.

Can OPM Use This Information for Employment Decisions?

The notices indicate the data are intended for health program administration, cost analysis, fraud prevention, and oversight, not human resources management. Nothing in the notices authorizes agencies to use individual health claims data in hiring, disciplinary actions, security clearances, or performance evaluations. Any such use would require separate legal authority.

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