- Client Satisfaction Survey on UNHQ administered health insurance programme, 19 March 2021
- UN SYSTEM-WIDE COVID-19 VACCINATION PROGRAMME
- Empire and Aetna Pharmacy Formulary changes, efective 1 January 2021
- UN Health and Life Insurance section conducted an infromation session on ways to contain costs and avoid steep premium increases. 16 December 2020 Presentation here.
- On Wednesday 11 November, HLIS organized an information session to guide us through the various Pharmacy Programs Read more and wathc session here.
- See the letter Re ASHI, which is being sent by the Health and Life Insurance Section with the statement reflecting revise premiums to individual retirees
- Mr. Jayantilal Karia, AFICS/NY Vice-President and Co-Chair, Insurance Committee: ASHI Remarks at AFICS/NY Annual Assembly, held virtually, 23 June 2020
- USA based ASHI Medical Insurance & TeleHealth Coverage
- Health and Life Insurance Section has informed that Empire Blue Cross Blue Shield (EBCBS) has introduced a new pharmacy benefits manager called IngenioRx effective 1 January 2020. We encourage those insured by EBCBS to read the information available on HLIS website here.
- Update of Insurance Premium rates and changes to the plans effective 1 July 2019 provided by the UN Insurance Section. Please be informed that individual letters to ASHI participants reflecting new premium rates will be be mailed during August. See the HLIS announcement here.
- We are delighted to announce the creation by the United Nations Health and Life Insurance Section (HLIS) of a hotline for retirees regarding their health insurance matters. AFICS/NY has been strongly advocating for the past couple of years for such dedicated service for retirees, especially for the additional capacity to provide it. AFICS/NY was informed by HLIS that it has established a dedicated telephone line that retirees can call with any questions concerning ASHI (After-Service Health Insurance). The phone number for that dedicated line is 917-367-9727 and it is now operational, according to the following schedule: Monday, Wednesday, Friday: 9.00 a.m. - 12:00 p.m.; Tuesday, Thursday: 10.00 a.m. - 12:00 p.m. and 2:00 p.m. - 4:00 p.m.
- The Health & Life Insurance Section indicates that Empire BlueCross BlueShield has recently mailed new ID cards to plan members. Empire BlueCross BlueShield issued new ID cards to give plan members a better experience at the drugstore. The new ID card will reflect new, Anthem-owned BIN and PCN numbers (used for processing prescription drug claims) and toll-free numbers for Pharmacy Member Services. These changes will help direct members and pharmacists to the right support, when they have questions about drug benefits. Members are advised to discard of their old cards and start using the new cards when they receive them.
- IMPORTANT UPDATE! Starting in April 2018, new Medicare cards started to be issued, and no longer contain Social Security Numbers. You can sign-up at medicare.gov to stay up-to-date on information about the new card, Once members receive their new Medicare Card (with the new number replacing the previously-used Social Security Number identifier), the Health & Life Insurance Section (HLIS) indicates that they must be provided a copy, being sure to include your full name, index number, mailing address and email address. This copy may be sent via email using email@example.com or by fax at (917) 367-1670. Please note that failure to provide the updated Medicare information to the HLIS may affect the processing of your claims.
- As reported by Mr. Karia, AFICS/NY Vice President and Co-Chair, Insurance Committee, at the AFICS/NY 48th Annual Assembly on 25 June, some eligible retirees are not being reimbursed for their Medicare premium as they have not submitted the required documentation to the Insurance & Disbursement Service (IDS). Retirees are urged to verify that they are being reimbursed for Medicare premiums paid by them directly, or through deductions from their Social Security payments. Anyone having problems on Medicare Part B premium reimbursement should inform the UN Insurance Service.
- July 2018 Renewal Memorandum to all ASHI participants in the UNHQ Health Insurance Programme has been mailed. PDF copy of the 20 June 2018 memo is posted below.
Retirees and active staff who have Aetna or Empire Blue Cross coverage, traveling or working 100+ miles away from home, can obtain emergency medical, travel and personal security assistance 24 hours a day, anywhere in the World through UnitedHealthcare Global (UHCG). UHCG is a programme providing emergency medical assistance management — including coordinating emergency evacuation and repatriation — and other travel assistance services.
Although you are automatically enrolled as an Aetna or Empire Blue Cross subscriber (with the cost built into the premium), to obtain the UHCG ID Card to use for access to the UnitedHealthcare Global Emergency Response Center, you must first create an online account and register with the UN’s UnitedHealthcare Global Assistance ID# 33211. Once registered, logging into the UnitedHealthcare Global Intelligence Center (via desktop or mobile device) will give you access to Medical Intelligence Reports, Medical & Security Alerts (including access to a free Daily Travel Alerts email subscription) and other travel tools.
[for Login via Mobile Device] m.members.uhcglobal.com
* NOTE * The UHCG ID card will have the vital information needed to use in the event assistance is needed: UN Policy Number, toll-free (US/Canada) and collect-call numbers, and the UHC Global email address. Be sure to also have your Aetna or Empire Blue Cross Insurance information card available during the call as you will be asked to provide this for confirmation of coverage.
The ST/IC/2018/15 Information Circular (Annex VII) extract posted below provides details on the programme’s services: Medical Assistance, Travel Assistance and Online services. It also contains important instructions on how to use the service plus a list of international toll-free access numbers. Download and keep to bring!
Also provided below are instructions provided by the Health & Life Insurance Section to assist in creating a UnitedHealthcare Global Intelligence Center Account.
UN Health & Life Insurance Section's link below provides Carrier information, summary of benefits, cost and eligibility details on their site.
> Two (2) GS staff will be joining the Insurance Service as dedicated resources to promptly address retiree’s individual issues.
> A number of Medicare Part B reimbursements are being held in suspense accounts awaiting the submission of appropriate documentation by retirees eligible for this reimbursement.
> The Health and Life Insurance Committee (HLIC) has reviewed a number of cases where medical costs for some participants were higher than established thresholds of various insurance plans, and AFICS ensured that all cases were treated in a fair manner.
> The HLIC has held weekly meetings for the last three months with representatives of various Medical plans to review the overall experience in the use of the plans by the Participants in preparation for the 2018 renewals. Some of the main issues reported were (1) escalating costs of medical treatments, especially for pharmaceuticals, (2) an increasing trend in the use of Emergency Rooms in hospitals, and (3) use of out-of-network physicians and other service providers such as physical therapists.
> After a number of intense discussions to review various options presented by the Administration, the HLIC has agreed to some changes in the premiums and benefits, first ensuring that these are kept to a minimum with adequate reserves for each plan.
> In order to ensure that future premium increases are kept to a minimum, members are urged (1) to discuss with their physicians the use generic medicines, which are significantly less expensive, (2) to use Urgent Care facilities instead of Emergency Rooms, which are more expensive in both the plan’s costs and in Co-Pay charges to Participants ($75 vs $25), (3) to use in-network providers, and (4) to use the Active Health Programme in the management of chronic conditions such as diabetes, hypertension, etc.
ASHI - After-Service Health Insurance
The United Nations offers optional After-Service Health Insurance coverage for eligible former staff members and their dependants. It is available only as a continuation, without interruption between active service and retirement status, of previous active-service coverage in a contributory health insurance plan of the United Nations.
- Staff members are reminded that, among the eligibility requirements for after-service health insurance coverage, the applicant must be enrolled in a United Nations scheme at the time of separation from service.
- It should also be noted that only family members enrolled with the staff member at the time of separation are eligible for continued coverage under the programme.
Enrolment in the after-service health insurance programme is not automatic. Application for enrolment must be made within 31 days following the date of separation. Full details on the eligibility requirements and administrative procedures relating to after-service health insurance coverage are set out in administrative instruction ST/AI/2007/3 (available below), dated 1 July 2007.
The UN Health & Insurance Section offers an online form to submit any questions or inquiries you may have. They indicate that you will receive a confirmation e-mail after submitting the form, and that your submitted form will be routed to the appropriate party in the Health and Life Insurance section for processing. The Section will strive to initiate a response to all request within 3 business days.
ASHI Memo to UNHQ Participants
On their website, the UN Health & Life Insurance Section indicates that for most benefits activities a form must be completed, and provide links to the forms required for most Health and Life Insurance actions. Following is what you will find of relevance:
> Health Insurance: Enrollment
Information on determining insurance plan eligibility and steps to follow.
> Health Insurance: Claims
Guidelines for submitting a claim.
> Health & Life Insurance: Conversion
Information on options available to continue health insurance coverage once leaving the UN insurance programme.
> Medicare Part B
Summary of Medicare Part B requirement for all eligible ASHI participants, plus links to Medicare-related forms:
- Medicare Part B Annual Reimbursement Form
- Medicare part B Bank Information Form
- Declaration of Medicare Ineligibility
> 2018 Annual Campaign – Deductible Credit Request
Information on addressing existing out-of-network expenses if you are moving from Aetna to Empire or the reverse during the Annual Insurance Campaign period, usually held in the month of June.
Checklists developed by the Health & Life Insurance Section to assist staff members, retirees, surviving spouses in providing the necessary documentation for special situations of relevance:
- Surviving Spouse (and dependent children in applying for ASHI)
- Medicare reimbursement
- Medicare ineligibility
- ASHI application checklist
TIPS FOR FILLING IN FORMS
Following are the related UNHQ current health insurance circulars on the UN Health & Life Insurance Circulars page, providing information regarding:
- Premiums and contribution rates
- Annual enrolment campaign
- Eligibility and enrolment rules and procedures
- Plan details such as summary of benefits, how to file a claim, conversion privileges, etc.
HQs Health Insurance
- ST/IC/2018/15: Renewal of the United Nations Headquarters-administered health insurance programme effective 1 July 2018
After Service Health Insurance (ASHI)
- ST/AI/2007/3: After-service health insurance
- ST/IC/2011/3: After-service health insurance: eligibility for subsidy to contributions to Medicare
Medical Insurance Plan (MIP) for Locally Recruited Staff
- ST/AI/2015/3: Medical Insurance Plan for locally recruited staff at designated duty stations away from Headquarters
- ST/IC/2015/8: Medical Insurance Plan for locally recruited staff at designated duty stations away from Headquarters
- Aetna PPO US Based plan - Active staff members
- Aetna PPO US Based plan - Medicare Retirees
- Aetna PPO US Based plan - non-Medicare Retirees
- Empire Blue Cross/Blue Shield PPO US Based plan
- HIP HMO US Based plan
- CIGNA PPO US Based plan
- UN Worldwide Health Plan
- MIP Local Based plan
UN Health and Life Insurance Section
|firstname.lastname@example.org||Active staff email|
|Note: All emails are tracked via iNeed and responses are sent from email@example.com.|
|Mondays to Fridays: 1:00 pm - 4:00 pm||Client service hours|
|FF-300 (3rd floor)||Office Location|
|304 E. 45th St., New York, NY10017 USA|
|(212) 963-5804||Health Insurance Inquires|
|(917) 367-1670||Office Fax Number|
|(917)- 367-9727||DEDICATED MEDICARE PHONE LINE FOR RETIREES|
Monday, Wednesday, Friday:
Following are the related health plan descriptions and carrier information provided by the UN Health & Life Insurance Section:
Dental (US Based) This plan covers dental care only. The dental PPO programme offers a large network of participating providers in the Greater New York Metropolitan area and nationally.
Medical/Dental (International - Non-US) The UN Worldwide Plan administered by Cigna covers staff members and former staff members who reside in all parts of the world, except the United States of America.
Medical/Dental (Locally Recruited - Non-US) The Medical Insurance Plan (also called “MIP”) is a plan for locally recruited staff, retirees and their eligible dependants at designated duty stations outside of UN Headquarters. It is voluntary for retirees who meet the eligibility criteria for after service health insurance coverage.
Medicare Part B Requirement for ASHI Participants
What is Medicare?
Medicare is the US federal health insurance program for people who are 65 or older. It has different parts that cover specific services. Medicare Part B (Medical Insurance for US-based doctors) helps cover doctors' services, hospital outpatient care and home health care, as well as some preventive services to help maintain your health and to keep certain illnesses from getting worse. This coverage, called Original Medicare, is what you need if you are a retiree enrolled in a New York Headquarters plan.
You are eligible for Medicare Part B if you are a US Citizen or have lawfully resided in the United States for a minimum of 5 years, including periods under a G-4 visa.
< Key Points >
> Effective 01 January 2011, the UNHQ Medical Programme required all UN After Service Health Insurance (ASHI) participants and their dependents enrolled in a US-based plan, who have reached the age of 65, to enroll in Medicare Part B as soon as they become eligible in an effort to contain medical costs.
> If you are entitled to US Social Security payments, you will be automatically enrolled as you approach age 65 and should receive a card in the mail. If you are not entitled to Social Security or if you declined to enrol when you reached age 65, but need to enrol in Medicare Part B, you may do so by contacting your local Social Security Administration office. You can locate your local office by going to the Social Security Administration (SSA) website, www.socialsecurity.gov.
> Medicare Part B enrollees must pay a monthly premium, for which ASHI participants will receive a full subsidy from the UN. All participants must provide a copy of their Medicare statement to the UN Insurance and Disbursement Service as evidence of payment of the Medicare Part B premium on a yearly basis in order to receive the subsidy. Further details are provided below.
> If you (and/or other family member) are deemed not eligible for Medicare Part B by your local Social Security Administration (SSA), the Insurance and Disbursement Service indicates that this needs to be reported to them. Please provide the document from the SSA indicating this information along with the Declaration of Medicare Part B Ineligibility form (available below) and a copy of your passport or residency card, whichever applies to your situation. This is important as this document will waive your carrier’s adjudication of your claims.
The UN’s Insurance and Disbursement Service has prepared a comprehensive Medicare FAQ document, posted below, with the following sections:
- Section I: Eligibility & enrolment
- Section II: Benefits
- Section III: Coordination of Benefits (COB) & claims
- Section IV: UN subsidy/Reimbursement
- Section V: Miscellaneous
For further information on Medicare and Medicare Part B, the Association has a separate page on this website under US Resident Issues; use the link below for easy access. Also provided below is a link to the UN Insurance website page and the US Federal Government’s official Medicare website.
Subsidy Related to Participatory Contributions in Medicare Part B
“ActiveHealth” is a new health benefit programme now available to all Aetna and Empire Blue Cross health insurance plan participants to improve health management and lower health insurance costs. Enrollment is automatic but only for Aetna and Empire.
UN Health & Life Insurance provides additional information and two short movies about ActiveHealth.
You must provide written notice to the Insurance Service with request for any changes. Information relating to insurance should not be sent to the Pension Fund. However, change of address request must be sent to both the Insurance Service and the Pension Fund, since these two systems are not electronically linked in any way. Any request for changes must be made by the primary insured and not any other person, unless we are provided with a Power of Attorney authorization to do so.
You may elect to change plans at retirement or remain in your present plan. You will be required to remain in the chosen plan at retirement for a minimum of 2 years before you are allowed to change plans. You may request this change by sending a written request to the Insurance Service. Do not send notice to the Pension Fund. If you are retiring in the United States or you have covered dependants in the United States, you cannot enroll in the Van Breda plan. The Van Breda plan is for staff members who are residing outside of the US and do not have dependants living in the US. US-based retiring staff members or those with US-based dependants must elect a US-based Insurance plan.
In cases of change of country of residence, the two year wait period does not apply. You may request to switch to the UN Worldwide Plan in writing when leaving the US for a long period of time. Please note that you will need to provide an overseas address.
If one spouse retires from service with the Organization before the other spouse, the spouse remaining in active service must become the subscriber. This applies even if the retired spouse had been the subscriber up to the date of retirement and is otherwise eligible for after-service health insurance coverage following separation from service. If both staff members have separated from service and if each individually is eligible for after-service health insurance coverage, the cost of the contribution towards the after-service health insurance coverage must be borne by the former staff member with the higher pension.
The following briefly summarizes ASHI eligibility requirements for retiring staff members and their eligible dependants. For more exhaustive information, please refer to ST/AI/2007/3.
- Must be a staff member of the UN, UNICEF, UNDP, UNOPS, UNFPA, UN WOMEN. Staff members retiring from the liaison offices of some UN System organizations who were covered through the Direct Billing Programme are also eligible for ASHI coverage.
- Must be at least 55 years old or over;
- Must be enrolled in a UN Health Insurance plan at the time of retirement;
- Must elect to receive a monthly pension benefit. The pension may be deferred up to full retirement age, but withdrawal settlements make a retiring staff member ineligible for ASHI.
- Must have at least 10 years of health insurance participation under an eligible contract for subsidized ASHI participation. If less than 10 years of health insurance participation but more than 5 years of health insurance participation under an eligible contract and the staff member was hired before 1 July 2007, the staff member is eligible for unsubsidized ASHI participation until the 10 year requirement is met. For those hired on or after 1 July 2007, the eligibility requirement is 10 years under an eligible contract for ASHI participation and for subsidy. This means that they cannot continue their insurance coverage under ASHI unless they have accumulated 10 years of insurance participation at the time of retirement while employed under an eligible contract;
- Staff members and dependants granted a disability benefit by the UNJSPF (age and participation requirements are waived in these cases).
Dependants covered at the time of the staff member’s retirement are eligible to continue their coverage provided:
- The staff member applies for them when applying for ASHI;
- Dependant children have not reached age 25 at the time of retirement, except in case of disability
- That they have been covered for at least five years (or two years if they were covered by a government or private insurance) in the case of a staff members hired on or after 1 July 2007 (please see ST/AI/2007/3 for more details) except of course newly acquired dependants.
- If a dependant child is disabled and 25 or older, the disability must be certified by the Pension Fund.
- Surviving spouses and dependants of active or retired staff members are also eligible provided they were covered under the staff member’s policy at the time of his/her death.The application time limit for Surviving spouses and children of staff members who die in service is of ninety (90) days following the staff member’s passing.
Important Consideration: Please note that in accordance with the ASHI AI and Section 7.3 of ST/AI/2001/2 the participatory years under the limited duration appointment are not included in the calculation of eligibility as the rules state enrolment in a United Nations contributory health insurance plan by a staff member under an ALD appointment shall not be counted for the purpose of determining eligibility for coverage under the United Nations after-service health insurance programme.
Affordable Care Act (ACA)
We have had some inquiries about the possible impact of the Affordable Care Act (ACA), also known as "Obamacare", on UN After-Service health plan benefits. Please be assured that there should be no impact on any UN retiree, dependent or survivor who is covered by a UN After-Service Health Insurance plan because it is unlikely that those mandated by the ACA would provide better coverage. The UN plans are not affected by the new legislation and will continue to be available to the retirees who participate in them.
UN Health Insurance Programme in brief
- Health insurance plans are either:
a) US-based for staff members in the United States and retirees whose country of residence is the US. If a non-US based staff member has a family member residing in the US, or plans to seek care in the US, then they have the option of selected a US-based plan.
b) Non-US for internationally recruited staff members.
c) Non-US for locally recruited staff members.
- The UN health insurance programme is a mostly self-funded health benefit plan, meaning that the yearly contributions paid by the participants and the subsidy paid by the UN (collectively referred to as “premiums”) are used to cover actual claim costs plus a fixed administrative fee.
- The General Assembly has mandated cost-sharing ratios between the staff and the UN towards the cost of the programme. The premium cost a staff member will pay to be a participant each year is based on the cost of medical or dental treatment received by United Nations participants in the plan in the prior year and projected costs for the current planned year which run from July to June.
- Health insurance provisions are described in the Staff Rules and in the annual Information Circular published each year to detail the policies, rates, terms and conditions of insurance benefits.