Frequently Asked Questions: Health Insurance - Administrative FAQ

Health Insurance - Administrative FAQ

What are the premium rates for 2014?
Single  $443.00  ($5,316.00 annually)

Family: $960.00  ($11,520.00 annually)
I just started working here, what paperwork do I need?

Stipend paid NIH fellows (such as IRTAs, CRTAs, Visiting fellows, etc.) must provide signed pages of 1, 2 and 3 of their stipend award forms to the FAES office. For J-1 visiting fellows please also bring your J-1 form (829-6) from Department of Immigration.

Who is Kelly and Associates and why am I receiving mail from them?

Kelly and Associates is the third party administrator for FAES,  They will send members notices for billing, COBRA, new information or changes that occur with the FAES insurance program.

  • Call center number for Kelly and Associates is 1-800-733-8166 or email them at  info@kaig.com
  • Please feel free to contact them for issues listed below at 1-888-708-7192.
    • Please call them to address CareFirst BC/BS benefits information
    • Please call them to request new card(s) and/or replacement card(s)
    • Please call them to address prescription, vision, and doctor issues
    • Please call them to address general claim issues
    • Please call them to address payment issues
What do I do if I want to keep my own insurance? Is my reimbursement taxed? (yes @ 14%)
  • If you are “not” on a J1 Visa, then provide your administrative office with proof of coverage and page 6 of your award forms.
  • If you are on a J1 Visa, then provide FAES with proof of coverage and the 829-6 form.

If  you are eligible for reimbursement, please provide FAES with:

  • Current award forms pages 4 & 5
  • Proof of coverage that shows policy#, group#, and enrollment date
  • Proof of monthly payment(check stubs, receipt from company, cc or bank statement
  • FAES will review, calculate your monthly insurance premium, update pages 4 & 5 (this process can be done monthly, quarterly, or yearly , as long as proof of payment is provided for the monthly, quarterly, or yearly reimbursement)
  • You AO will be sent the originals, the fellow is given a copy, and a copy is kept on file at the FAES office for future reimbursements.
  • If your award forms expire, the FAEs rep will ask you to bring updated forms
  • Please advise FAES when your medical premiums increase or decrease so that the proper adjustments can be made. Please advise FAES if you change your insurance plan to insure accurate records.
  • If you do not receive any reimbursement amount after your paperwork has been processed by FAES please contact your administrative office.
My award changed, can I enroll now?
  • No, you are only allowed to enroll within your first 30 days of employment and/or a qualifying event for special enrollment that recently occurred and 30 days have not expired from the date of the occurrence.
  • NIH states that all fellows need to have adequate health coverage while working here, so the fellow should have had “other coverage” while under the old award and the fellow will need to maintain the other coverage. The fellow is welcome to enroll in the FAES plan during Open Season(Nov 1st-30th) and the coverage will start January 1st of the following year.
  • Some qualifying enrollment reasons:
    • Loss of other coverage
    • Change from part-time to full time
    • Entry into the USA
What is ABS? Why is a reactivation from ABS important?

ABS = Absent without stipend (NIH will not pay you while on leave)

  • The forms need to be submitted to FAES in a timely manner to insure that you are terminated on time and COBRA coverage is offered. FAES prefers if the form can be sent one month in advance or before the month that you are leaving expires.
  • FAES requires a Reactivation of Stipend form upon your return to NIH to determine the actual date that the member returned to work and to determine if the member has to pay for any “Gap” in coverage before we can start billing the institute.
  • It is important for the fellow to contact the FAES insurance office upon returning to work at NIH to get a status of their health insurance.
Is my insurance automatically renewed? Will I get a new card when I renew?
  • Insurance is NOT automatically renewed. Renewal of insurance corresponds directly with renewal of fellowship. Fellow must provide FAES with new Election of Health Insurance forms, obtained from his/her Administrative Officer, before the 24th of the renewal month. If renewal paperwork is not provided in time, the insurance will terminate as of the 30th. Once paperwork is received, FAES will reinstate coverage back to the date of termination.
  • No, a member does not get a new card upon renewing. Members should use the same insurance card and information.

 

My AO is unable to provide me with my paperwork until the day my award is renewed, so will my coverage terminate?

Your Administrative Officer (A.O.) DOES have the ability to renew you in FPS before your renewal date.  If you are not renewed in a timely manner you will be terminated.