.
• US citizenship and SS benefits not required to enrol
• Enrol at any SS office before you turn 65 years
• Claims adjudication will assume you have Medicare B even if
you do not enrol
10
2016-2017 plan year
11
Overview of the past plan year
• Plans’ experience has been generally
favourable
– Expenses increased but at lower rate than prior
years
– Positive impact to projected requirements for the
new plan year beginning 1 July 2016
• Aetna was the exception
– 4% increase in medical expenses
– 16% increase in pharmacy expenses
– Projected increase in requirements for the new plan
year of about 12.62% following relative stability
over the past two years
12
Insurance Renewal 2015
Premiums for 1 July 2016 – 30 June 2017
Empire Blue Cross 1.50 % increase
HIP 1.80 % increase
Cigna dental no change
UN Worldwide 0.60% increase
(formerly known as Vanbreda)
13
Insurance Renewal 2015
Aetna premiums will increase by 4.65% only
No premium holiday declared for 2016-2017
Benefit changes effective 1 July 2016
Branded prescription drugs co-insurance will
increase to 25% with a maximum of $30 per 30-day
prescription
Generics remain at 20% up to a maximum of $20
Emergency room co-pay will increase from $50 to
$75 but will be waived if it results in an admission
Aligns with co-pay/co-insurance under the Empire Blue Cross plan
14
Insurance Renewal 2015
Benefit changes effective 1 July 2016 (Aetna)
Annual out-of-pocket maximum will increase from
$1,250 to $1,500 per person or from $3,750 to
$4,500 per family when using out-of-network
providers in the US
Out-of-pocket maximum must be met before the plan will
reimburse at a higher percentage
Deductible remains $250 per person/$750 per family
15
Insurance Renewal 2015
How to minimize the impact of the benefit changes
Use of generic drugs whenever possible
Greater use of urgent care facilities for non-
serious medical issues
MedRite Urgent Care
CityMD
Use of in-network providers
16
Insurance benefits
Telemedicine under the Aetna
and Empire Blue Cross plans
Teladoc (Aetna) effective 1 July 2016
LiveHealth Online (Empire) currently available
Live video consultations with a US-based certified
doctor 24/7 using smartphone, tablet or computer to
discuss non-emergency health issues from home, work
or wherever one may be with internet access
Pay same $15 co-pay for primary care provider
Sign up for these services by going to Aetna or
Empire’s websites
17
Insurance benefits
ActiveHealth benefits included in
the Aetna and Empire Blue Cross
plans
Nurse Care Programme for management of chronic
conditions
Personal health coach (US-registered nurses)
One-on-one education and support
Regular calls arranged at your convenience
Information by mail
40 chronic conditions like hypertension, diabetes,
asthma, COPD, osteoporosis, chronic hepatitis B or C,
Crohn’s disease, migraines, cancer
24 hour informed health line (800-556-1555)
Access to registered nurses
Audio library
18
UN ASHI programme
• ASHI is same plan you had as an active staff
• Plan changes for ASHI participants
– Allowed once every two years in the US
• Enrol in US plan if you seek care in the US
• Self-insured programme
– Member behaviour/choices influence premiums
– Insurance companies have no incentive to deny
coverage
• Carriers paid fees of 3% to 4% of plan cost
– Administrative services
– Provider networks and expert services
19
Cost Containment
• All plan participants are responsible for
using benefits wisely
– Use in-network providers
– Research and understanding costs prior to
treatments
– Consider alternative treatment facilities (stand-
alone facilities vs hospitals; and urgent care centers
vs emergency rooms)
– Secure prior approval when required
– Use of generic drugs whenever possible
– Compare cost of mail order drugs to cost of retail
drugs
20
Other reminders
21
Re-employment at the UN
• Eligibility to ASHI
ceases when a former
staff member re-enters
UNJSPF as a
participant following
re-employment
• Must re-enrol and contribute as active staff
– Implications for Medicare
• Upon separation, must re-enrol to activate ASHI
– No automatic reinstatement
22
UN Health and Life Insurance website WWW.UN.ORG/INSURANCE
• Visit our website on a regular basis for information
23
www.un.org/insurance
Language:English
Score: 1055386
-
https://www.un.org/other/afics...s/2016_ashi_presentation_0.pdf
Data Source: un
Some biotherapeutics are effective treatments for certain forms of cancer, chronic diseases such as diabetes, Crohn’s disease and other autoimmune conditions, including lupus, and various forms of rheumatoid arthritis.
Language:English
Score: 1026829.3
-
https://www.who.int/news/item/...saving-breast-cancer-treatment
Data Source: un
Some biotherapeutics are effective treatments for certain forms of cancer, chronic diseases such as diabetes, Crohn’s disease and other autoimmune conditions, including lupus , and various forms of rheumatoid arthritis.
Language:English
Score: 1026829.3
-
https://www.who.int/news/item/...osimilars-for-cancer-treatment
Data Source: un
Elma Witherspoon, Acting Chief of Section
www.un.org/insurance
2018-2019 plan year
www.un.org/insurance
• Overview of the past plan year • Plans’ experience required increases
• Expenses increased at a higher rate than prior years
• Increase in the use of out of network providers by plan members of self funded US health plans
• UN WWP participants obtaining care in the US
• As a result the contributing organizations and all plan participants will see an increase in contributions
Insurance Renewal 2018
www.un.org/insurance
Insurance Renewal 2018
www.un.org/insurance
Premiums for 1 July 2018 – 30 June 2019
Aetna 3.50% increase Empire Blue Cross 4.75 % increase HIP 9.17 % increase Cigna dental 2.50 % increase UN Worldwide 2.50 % increase
Benefit changes effective 1 July 2018 (Aetna)
• Reduce benefits by $2,500 if plan members fail to obtain pre-authorization for inpatient hospitalization services
• In-network providers are responsible to obtain pre- authorization
• You or your provider are responsible to obtain pre- authorization if you go to an out-of-network provider
Insurance Renewal 2018
www.un.org/insurance
Benefit changes effective 1 July 2018 (Empire)
• Reduction in the reimbursement rate for out-of-network providers (except physical therapists) from 395 per cent of Medicare to 275 per cent of Medicare in order to better align reimbursement practices with current market standards
Insurance Renewal 2018
www.un.org/insurance
www.un.org/insurance
Benefit changes effective 1 July 2018 (UN WWP)
• Increase of ceiling for annual check-ups from $750 to $1,050
• Introduction of Cigna’s Telehealth service to all Cigna Worldwide Plan participants
Insurance Renewal 2018
www.un.org/insurance
How to minimize the impact of the benefit changes
• Use in-network providers
• Use Urgent Care Centers instead of ERs when possible
• Refrain from travelling to the United States for medical treatment if enrolled in the UN WWP
Insurance Renewal 2018
• Teladoc (Aetna)
• LiveHealth Online (Empire) currently available
• Live video consultations with a US-based certified doctor 24/7 using smartphone, tablet or computer to discuss non- emergency health issues from home, work, or wherever one may be with internet access
• Pay same $15 co-pay for primary care provider
• Sign up for these services by going to Aetna or Empire’s websites
Insurance Benefits Telemedicine under the Aetna and Empire Blue Cross plans
www.un.org/insurance
www.un.org/insurance
• Nurse Care Programme for management of chronic conditions • Personal health coach (US-registered nurses) • One-on-one education and support • Regular calls arranged at your convenience • Information by mail • 40 chronic conditions like hypertension, diabetes, asthma, COPD,
osteoporosis, chronic hepatitis B or C, Crohn’s disease, migraines, cancer
• 24 hour informed health line (800-556-1555) • Access to registered nurses • Audio library
Insurance Benefits ActiveHealth benefits included in the Aetna and Empire Blue Cross plans
• Telehealth (Cigna International)
• Cigna’s Telehealth connects patients to licensed doctors around the world via telephone or video for non-emergency health issues
• 24/7 access, with appointments set within 48h for General Practitioners
• The doctor assigned is based on date, time and language preference in your particular time zone
• Sign up for these services by going to Cigna’s website
Insurance Benefits Telemedicine under the UN WWP plan
www.un.org/insurance
All plan participants are responsible for using benefits wisely
• Use in-network providers • Research and understand costs prior to treatments • Consider alternative treatment facilities (stand-alone
facilities vs hospitals; and urgent care centers vs emergency rooms)
• Secure prior approval when required • Use of generic drugs whenever possible • Compare cost of mail order drugs to cost of retail
drugs
Cost Containment Reminders
www.un.org/insurance
www.un.org/insurance
Customer Service Update
• AFICS representatives to the Health and Life Insurance Committee were instrumental in getting two new posts to provide customer service to retirees enrolled in Medicare
• The selection process is completed and staff will be on board within two to four weeks
• ASHI is same plan you had as an active staff
• Plan changes for ASHI participants • Allowed once every two years
• Enrol in US plan if you seek care in the US
• Self-insured programme • Member behaviour/choices influence premiums • Insurance companies have no incentive to deny coverage
• Carriers paid fees of 3% to 4% of plan cost • Administrative services • Provider networks and expert services
UN ASHI Programme Overview
www.un.org/insurance
Medicare
www.un.org/insurance
Medicare B Reimbursements
Change in reimbursement process
• Medicare premiums paid directly to retiree’s bank account
• No longer applied against ASHI contributions deducted from monthly pension
• Pension payments now reflect the true cost of your ASHI contributions
• Changes in pension amounts in April if there is COLA; in July if there are rate increases; or if there are changes to coverage level or plan; e.g., from “Family” to “Retiree and one family member”
• Timely reimbursement of correct premiums instead of offsetting which can take months if retroactive amounts are involved
• Now require updated banking information
www.un.org/insurance
Important reminders for current Medicare retirees
• If not yet provided, submit banking information to UN • Ensure correct bank account numbers • Ensure correct routing information of your bank • Provide voided cheque as much as possible • Bank account must be in retiree’s name even if spouse is the one
enrolled in Medicare • Provide updated banking information if there are changes • Provide updated mailing address to UN • Information provided to UNJSPF not shared with UN
Medicare B Reimbursements
www.un.org/insurance
Medicare
www.un.org/insurance
• US-based retirees and their spouses must enrol in Medicare Part B at age 65 • Only applicable for plan participants of Aetna, Empire Blue Cross
and HIP
• Only Medicare Part B monthly premiums are reimbursed
• DO NOT enrol in Medicare D • UN’s plans provide just as good as, or better coverage
• Ignore advertisement and media hype about Medicare Advantage plans or Medicare Part D (prescription drugs)
Existing Participants • Submit cost information from Medicare early
• Only if your premium is not the standard amount • Fourth quarter of current year for following year • Submit once a year only unless there are adjustments mid-year • Responsibility to be current with your Medicare payments
New Medicare Enrollees • Enrol if you have legally resided in the US for the past 5 years. • US citizenship and SS benefits not required to enrol • Enrol at any SS office before you turn 65 years • Claims adjudication will assume you have Medicare B even if you
do not enrol
Medicare
www.un.org/insurance
www.un.org/insurance
Other Reminders
www.un.org/insurance
• Eligibility to ASHI ceases when a former staff member re-enters UNJSPF as a participant following re-employment
• Must re-enrol and contribute as active staff • Implications for Medicare
• Upon separation, must re-enrol to activate ASHI • No automatic reinstatement
Re-employment at the UN
www.un.org/insurance
• Ensure that contact details – mailing and non UN email address are current
• Notify the Health and Life Insurance Section in writing
• Pension Fund will not notify the Health and Life Insurance Section
Contact Information
www.un.org/insurance
Social Security and Medicare are separate programs
• It is not necessary to be a United States (USA) citizen to be covered by Medicare Part B
• It is not necessary to contribute to Social Security to be eligible for Medicare Part B
• Medicare Part A and Medicare Part B benefits are only provided to ASHI participants who reside in the USA
Medicare
www.un.org/insurance
The UN does not reimburse Medicare Part B penalties
• The UN reimburses Medicare Part B premiums
• The UN does not reimburse Medicare Part A premiums
• The UN does not reimburse Medicare Part C premiums
• The UN does not reimburse Medicare Part D premiums
Medicare Reimbursements
Visit our website on a regular basis for information
WWW.UN.ORG/INSURANCE
www.un.org/insurance
Questions?
Language:English
Score: 999777.2
-
https://www.un.org/other/afics...on_2018_afics_presentation.pdf
Data Source: un
The dose used is the standard dose that patients with Crohn’s Disease are given over extended periods.
Language:English
Score: 974114
-
https://www.who.int/emergencie...-trial-for-covid-19-treatments
Data Source: un
La agencia de salud detalló que el artesunato es un medicamento para la malaria grave ; que el imatinib se usa para ciertos tipos de cáncer , como la leucemia; y el infliximab se utiliza para tratar la enfermedad de Crohn , la artritis reumatoide y otros padecimientos del sistema inmunológico.
Language:English
Score: 926546.9
-
https://news.un.org/es/story/2021/08/1495402
Data Source: un
NOTE /BY THE SECRETARY-GENERAL.
Intervent ions
by, intlsr al 93, MQni:r’ed Muullor, Kurt Spil lmann, Crohn Sull ivan, thmt.tzVo ZOUla,
(b) ElQuond ooosionr nucluar arms l imi ta t ion and reduation - b i l s t era l and
multil,atorol porapout ive (Cha irmanr Serge But, Dctputy Director of UNIDIR) l
8rQ8Qntatfon of roporta by Aloxfri Arbotov, David Emery, Pierre Lellouuho.
Language:English
Score: 858318.3
-
https://daccess-ods.un.org/acc...sf/get?open&DS=A/42/607&Lang=E
Data Source: ods
El artesunato se usa para la malaria grave, el imatinib para ciertos tipos de cánceres y el infliximab para enfermedades del sistema inmunitario como la enfermedad de Crohn y la artritis reumatoide.
Las empresas farmacéuticas que fabrican estas medicinas las donaron para el ensayo clínico.
Language:English
Score: 844109.4
-
https://news.un.org/es/story/2021/08/1495362
Data Source: un
Yes No
Yes No
Hepatitis (Do not check “Yes” for Hepatitis A) or Cirrhosis
Yes No
Blocked Arteries (Arteriosclerosis, Atherosclerosis, Aneurysm, or Deep Vein Blood Clot)
Yes No
Amyotrophic Lateral Sclerosis (ALS) or Multiple Sclerosis (MS)
Yes No
Stroke or transient ischemic attack (TIA) Yes No
Alzheimer’s or Parkinson’s Disease Yes No
Chronic Obstructive Pulmonary Disease (COPD) or Emphysema
Yes No
Paralysis Yes No
Diabetes Yes No
Major Organ Transplant Yes No
Depression Yes No
Chronic Fatigue Syndrome or Fibromyalgia Yes No
Sleep Apnea Yes No
Narcolepsy Yes No
Cancer (Do not check “Yes” for Basal Cell Carcinoma only)
If “Yes”, Date of Diagnosis:
_______________________________
Yes No
Ulcerative Colitis or Crohn’s Disease Yes No
Psychotic, Psychiatric, Personality, or Bi-Polar Disorder Yes No
Kidney Failure or Dialysis Yes No
Notice
To the best of your knowledge, you are required to notify Hartford Life and Accident Insurance Company in writing of any changes in your medical condition between the date you sign this form and the date the coverage is approved.
Language:English
Score: 808157.3
-
https://www.un.org/insurance/s...les/images/2019-eoi-form-3.pdf
Data Source: un
REVISION OF RESOLUTION NO. 31: STANDARDS FOR MEDICAL FITNESS
Case-by-case assessment based on
severity of symptoms when lying
down and on any sleep disturbance
caused by them
Case-by-case
assessment based on
severity of symptoms
when lying down and
on any sleep
ECE/TRANS/SC.3/WP.3/2020/24
13
ICD 10
Diagnostic
Codes
Condition
Justification for criteria
Incompatibility to perform assigned duties
at any time: expected to be temporary (T);
expected to be permanent (P)
Able to perform assigned
duties at any time
disturbance caused by
them
K 50, 51,
57, 58, 90
Non-infectious enteritis,
colitis, Crohn’s disease,
diverticulitis, etc.
Impairment and pain
T – Until investigated and treated
P – If severe or recurrent
Case-by-case specialist
assessment.
Language:English
Score: 775067.5
-
https://daccess-ods.un.org/acc...TRANS/SC.3/WP.3/2020/24&Lang=E
Data Source: ods