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2020 Annual Insurance Campaign
Info session for US-based plans
Health & Life Insurance Section (www.un.org/insurance)| DATE: 16 JUNE 2020
• Introduction - meet the participants of this session
• Health Insurance Plans - funded by me and you, our colleagues and our Organization
• Plan changes - applicable as of 1 July 2020
• Enrolment campaign process - what is expected from you in June
• Q&A – answers to your questions related to the enrolment campaign
Agenda
Third-Party Administrators Aetna, Empire and Cigna Dental
Participants
UN Health & Life Insurance Section together with the Health & Life Insurance Committee members
Staff covered under the US-based plans
Roles & responsibilities
Third-Party Administrators Insurer of our plans Plan Participants
• All plans are self-funded
• Decides on the benefits of the plans
• Determines who is covered under the plans
• Decides how reimbursements will be made
• HLIC is the advisory committee on insurance matters
• Process claims by following and applying the plan rules
• Respond to inquiries from plan members
• Provide a medical network of health care providers that offer both physical and visual consultations
• Fund a portion of the plans
• Understand the benefits and limitations of our plans
• Help keeping our plans sustainable, eg by visiting in-network providers.
UN health insurance principles
• Aetna PPO, Empire Blue Cross PPO and Cigna Dental PPO are all self-insured programmes
• General Assembly cost sharing mandate: 33% (staff) –67% (UN)
• Plan year: July - June
Coverage at a glance
Medical plans Aetna PPO & Empire Blue Cross PPO Dental plan Cigna Dental PPO
Benefits summary In-Network Out-Of Network
Annual deductible $0 $250/$750
Office-home visits $15/$20 80% after deductible
Routine physical $15 80% after deductible
Hospital- in-patient 100% 80% after deductible
Hospital: out-patient 100% 80% after deductible
• Covers diagnostic, preventive, restorative and orthodontic care
• Total reimbursements are capped but the maximum cap depends on you:
• Minimum cap is $2,250 a year
• Maximum cap can increase to $2,550 a year
Benefits summary In-Network Out-Of Network
Annual deductible & co-insurance
$0 10%-30%
Visit In-Network providers to avoid negative financial surprises!
Empire Blue Cross PPO
Key services already available to you
Aetna PPO
• Teleconsultations through“Teladoc”
• Health and wellness support through ActiveHealth
• Emergency medical assistance management through UnitedHealthcare Global Assistance and Risk
• Teleconsultations through“LiveHealth Online”
• Health and wellness support through ActiveHealth
• Emergency medical assistance management through UnitedHealthcare Global Assistance and Risk
• Aetna Maternity Program – support to help mother and baby grow healthier together;
• Coverage of habilitative physical, occupational, and speech therapies for developmental delays;
• Premium rate increase by 7.26%
Aetna PPO changes as of 1 July 2020
Aetna PPO plan changes
Questions on these changes? Contact Aetna!Phone: (800-784-3991)
Email: [email protected]
• Preferred generics - When an equivalent generic to a brand name drug is available, the member will pay:
• brand drug co-pay and
• the difference in cost between the generic and the brand name drug.
• Opt out Home delivery - For medications taken regularly, members can opt out of home delivery;
• Reduce out-of-network physical therapy and certified social worker reimbursement rates;
• Premium rate increase by 9%
Empire Blue Cross PPO changes as of 1 July 2020
Empire Blue Cross PPO plan changes
Questions on these changes? Contact Empire!Phone: 855-220-3341
Email: [email protected]
• Diagnostic or preventive care will NOT apply to the annual maximum;
• The regressive maximum feature will be turned off;
• Premium rate increase by 1.00%
Cigna Dental PPO updates for the upcoming plan year only (1 July 2020 – 30 June 2021)
Cigna Dental PPO plan changes
• No benefit changes
• Premium rate increase by 5.97%
HIP Health Plan of New York changes as of 1 July 2020
HIP plan changes
Enrolment and changes
Enrolment must be done:
• Within 31 days of appointment or reappointment
• During annual insurance campaign in June:
Changes due to a qualifying event
must be done within 31 days of the
event:
• Marriage/Divorce
• Death of dependant
• Marriage or full-time employment of child
• Change of duty station
• Change in dependent status
• Birth/legal adoption of a child
• Upon evidence of absence for enrolment
• Upon return from Special Leave Without Pay
(SLWOP)
• Upon an inter-agency transfer
Review your health insurance coverage and indicative data in Umoja ESS, SAP, Atlas or oneUNOPS in June!
Q&A
In addition, we kindly invite you to visit our website (www.un.org/insurance) and discover a
wealth of information available to you!
