September 1, 2023
FAES Open Enrollment: September 11-22, 2023 for Medical/Prescription, Dental, and Vision Plans for the 2023-2024 Plan Year
Since 1959, the Foundation for Advanced Education in the Sciences (FAES) has been working to support the professional and educational mission of the National Institutes of Health. This support includes a health insurance program for select members of the NIH community. Over the years, FAES has made many changes to ensure a robust and sustainable insurance plan for members.
FAES will continue to offer the Trustmark/Aetna Signature Administrators PPO Medical/Prescription plan and the MetLife Dental/Vision plans for the 2023-2024 plan year. We are pleased to announce that no coverage changes were made to the medical, dental, and vision plans for the new plan year.
Changes for the 2023-2024 plan year are:
- The prescription plan will have minor changes; please review the Benefits Guide for details.
- Talkspace services will be discontinued on October 31, 2023. Please note: Members can continue to seek mental health care from in- or out-of-network providers with office visits at the same $15 copay through the FAES medical plan. There are no restrictions when selecting a mental health provider since members can use the FAES medical plan to go to any provider nationwide.
The 2023-2024 Benefits Guide and insurance plan video will be posted on the FAES Explore Insurance Plans webpage ahead of Open Enrollment.
Open Enrollment is a time when members can make changes to their insurance election. Changes can include:
- Switching from individual coverage to family coverage (or vice versa),
- Dropping coverage altogether or
- Enrolling if they previously waived coverage.
If members wish to make changes, please contact the FAES Insurance department by email or phone. Changes will take effect with the start of our new plan year on November 1, 2023.
If members are currently enrolled and are not making any changes for the new plan year, they will not need to complete new paperwork.
FAES Insurance will host daily (Monday-Friday) Open Enrollment Information Sessions via Zoom, September 11-22 at 3 p.m.
Sessions via Zoom, September 11-22, 2023, at 3 p.m.
Zoom Meeting Details:
Link: https://faes-org.zoom.us/j/89407404931?pwd=YzVhN0E2c012TThoSjNOSUJCTjRtQT09
Meeting ID: 894 0740 4931
Passcode: 915492
July 18, 2023
Trainee Professional Liability Insurance
Effective June 1, 2023, FAES is excited to announce that all non-FTE trainees are now covered by the Trainee Professional Liability Insurance Program. The Liability Insurance Program offers both legal defense and financial liability coverage and protects covered trainees from allegations of misconduct. Please refer to this information flyer for more information.
COVID-19 Public Health Emergency
On May 11, 2023, the Federal COVID-19 Public Health Emergency declaration ended. While Insurance providers are no longer required to provide free at-home COVID-19 test kits, FAES has extended this benefit to members. The FAES plan will continue to provide 8 free at-home COVID-19 tests every 30 days from Express Scripts Pharmacy through end of the plan year, October 31, 2023. Afterwards test kits can be purchased over-the-counter at various retail and pharmacy locations. Treatment and vaccines for COVID-19 will continue to be covered under the Plan.
Trustmark Email Address Update for Claims
The dedicated Trustmark email address for claim submission has changed to HBEVClaimsubmission@hlthben.com. To avoid any delays in claims reimbursement, please ensure to use the new address. Please refer to the Trustmark claim form submission instructions.
December 15, 2022
Express Scripts Pharmacy Network Change
Starting January 1, 2023, Harris Teeter pharmacies will no longer be part of the Express Scripts pharmacy network. If you fill prescriptions at a Harris Teeter pharmacy, they will not be covered by the FAES pharmacy plan, and you may pay a higher cost for your medications. If you have recently or previously filled a prescription at a Harris Teeter pharmacy, you will receive a letter from Express Scripts informing you of participating pharmacies in your area. To avoid any interruption in your treatment, transfer your prescription to a participating pharmacy before January 1, 2023.
It’s easy to move your prescription. Here are 3 ways to make the switch:
- Take your prescription bottle to your new pharmacy and they’ll contact your current pharmacy to transfer your prescription.
- Call your new pharmacy and ask them to transfer your prescription.
- Ask your doctor to contact your new pharmacy with your prescription information.
Visit express-scripts.com/findapharmacy for a full list of in-network pharmacies near you.
Holiday Season Reminders
Urgent Care vs. Emergency Care
Holiday closures and travel can affect your options to receive medical care. Your best choice for non-urgent situations is always a scheduled appointment with your doctor, however when that is not possible, you have choices.
Urgent Care: Many situations require immediate care that you might not be able to receive in your doctor’s office, yet these situations might not be serious enough to require the services of a hospital emergency room. In these situations, a walk-in clinic or urgent care center may be an appropriate choice. Remember, care received in an urgent care facility is costly, yet much less expensive than an emergency room. Below are some guidelines to determine when an urgent care center is appropriate.
- You have telephoned your doctor or nurse practitioner and he or she recommends that you go to an urgent care center.
- Your symptoms or injury have occurred outside of your physician’s regular office hours and are too severe to wait until the next regular office hours, yet not severe enough to warrant a visit to the emergency room.
- You do not have a regular doctor or primary care physician.
- You are out of town.
- You are unable to reach your doctor or nurse practitioner by phone.
Emergency Room Care: A visit to the hospital emergency room is the most expensive type of outpatient care. Emergency rooms should only be used for true emergencies, as they are staffed, equipped, and best suited for medical emergencies. Going to an emergency room for non-emergency care is a poor use of your health benefits and can be very costly. Some situations where emergency room care is appropriate include:
- A major injury, such as a broken bone
- A wound that continues to bleed vigorously despite application of pressure
- Decreased mental activity or awareness, or disorientation
- Shortness of breath
- A cold sweat accompanied by chest pain, abdominal pain or lightheadedness
- Severe pain
When faced with deciding where to go to receive medical care, be sure to evaluate all your options and choose the setting that best suits your illness or injury. Of course, in a true emergency, seek the appropriate care without delay. Choosing the most cost-effective options will go a long way toward ensuring that your employer can continue to provide you and your family with the quality, affordable health benefits you rely on.
Talkspace Support
The holiday season is a joyous and festive time, but it can also be very busy and stressful. FAES plan participants have access to Talkspace therapy and psychiatry services at no additional cost. Please view the Registration Guide on how to get started.
Flu Season
Flu season is here. Don’t forget to get a Flu Shot to protect you, your family, and your community. Visit Vaccines.gov to find a flu shot near you.
Covid-19 Bivalent Booster and At-Home Test Kits
Covid-19 Bivalent Boosters are now widely available in our community. If it has been two months since you completed your primary vaccination series or received a booster, you are eligible for the Moderna and the Pfizer-BioNTech COVID-19 bivalent vaccine boosters. Visit Vaccines.gov to find a COVID-19 vaccine near you.
At-Home COVID-19 Test Kits: FAES plan participants can get free at-home COVID-19 tests in two ways:
- Express Scripts (ESI) Pharmacy: Order up to 8 at-home COVID-19 tests every 30 days from Express Scripts Pharmacy. Log in or register to place your order on express-scripts.com.
- Retail pharmacy: You can pick up tests from your local ESI-participating pharmacy. Purchase tests at the pharmacy counter and offer your benefit information for a $0 copay.
June 30, 2022
Machine Readable Files Available
FAES medical in-network rates and out-of-network allowed amounts are available as machine readable files via a new link on the FAES Insurance webpage. To access machine readable files with information specific to participants in the FAES Insurance Plan, please open the Healthcare Bluebook window and click on the link for Aetna Signature Administrators.
May 23, 2022
New Wallet Card and Provider Information Sheet
Trustmark will mail a new wallet card and provider information sheet to plan participants this spring. Plan participants can share the card and information sheet with providers when seeking care to assist the providers with verifying coverage and submitting claims to Trustmark. The documents also outline the relationship between Trustmark and the Aetna Signature Administrators PPO network. The wallet card can be carried along with your insurance card. An electronic version of both documents is available on the Trustmark portal and the FAES Insurance website.
At-Home COVID-19 Test Kits
FAES plan participants can get free at-home COVID-19 tests in three ways:
- Express Scripts (ESI) Pharmacy: Order up to 8 at-home COVID-19 tests every 30 days from Express Scripts Pharmacy. Log in or register to place your order on express-scripts.com.
- Retail pharmacy: You can pick up tests from your local ESI-participating pharmacy. Purchase tests at the pharmacy counter and offer your benefit information for a $0 copay. If you pay for the tests out-of-pocket, ask for a pharmacy receipt. Log in to your account on express-scripts.com for instructions on how to submit a reimbursement claim.
- Federal government: With the help of the United States Postal Service (USPS), households can request tests to be delivered for free. Learn more and order at-home tests at www.covidtests.gov.
May is Mental Health Awareness Month
Mental health impacts every area of our lives. Our mental health affects everything we do, think, or say. Maintaining positive mental health, and seeking treatment for any mental health condition, is crucial to stabilizing constructive behaviors, emotions, and thoughts. Focusing on mental health care can increase productivity, enhance self-image, and improve relationships.
Nurturing mental health doesn’t just improve daily functioning, it can also help control — or better cope with — some physical health problems that are directly linked to mental health conditions. Other benefits of taking care of your mental health can include:
- Improving your mood
- Reducing your anxiety
- Creating an enhanced sense of inner peace
- Thinking more clearly
- Improving your relationships
- Increasing your self-esteem
Available Mental Health Resources
FAES plan participants have access to mental health resources and providers through the FAES medical plan and Talkspace. The medical plan allows plan participants to seek mental health care from in- or out-of-network providers with office visits at the same $15 copay. Coverage is the same for mental health office visits to in-network providers and out-of-network providers. There are no restrictions when selecting your mental health provider; you can go to any provider using the FAES medical plan. Talkspace is a digital mental health service that connects members to thousands of dedicated providers through a secure, HIPAA-compliant platform. With Talkspace, you can interact with your therapist via text, voice, or video messages—anytime, anywhere—including from the comfort of your home. Talkspace also has a network of licensed prescribers specializing in mental health care and prescription management.
Please see the registration guide on how on FAES plan participants can access Talkspace services at no-cost.
March 30, 2022
FAES Health Insurance ID Card Redesign
All FAES plan participants will be issued a new health insurance ID card by mail in spring 2022. Each plan participant, including spouse and dependent children, will receive their own ID card with their name listed.
- Member IDs and group numbers have not changed.
- The top right quadrant of the card is now titled “Medical Provider Network.”
- In accordance with the “No Surprises Act,” the card will now list copayment amounts due for office and specialist visits, in- and out-of-network deductibles, and out-of-pocket maximum amounts.
- The “Medical Claims Submission” quadrant will now include additional information for providers.
- The new information “Claim Status Inquiry: Payer ID CRSMD” allows providers to check the status of submitted claims.
If you have an upcoming appointment and have not yet received your redeisgned health insurance ID card in the mail, you can still use your existing card. You can also access the most current health insurance ID card by registering for or logging into your mytrustmarkbenefits.com account.
The FAES Insurance Department is here to assist you with any questions you may have. Please do not hesitate to reach out to us for assistance. We are here to support you.
301-496-8063 | faesinsurance@mail.nih.gov
March 15, 2022
Clarification Regarding At-Home COVID-19 Test Kits Coverage
FAES would like to provide clarification on how at-home COVID-19 test kits are covered by the prescription plan with our pharmacy benefit manager, Express Scripts (ESI). When purchasing an at-home COVID-19 test kit, members will either:
- Purchase the at-home COVID-19 tests directly from an in-network pharmacy
- Purchase test kits at an in-network pharmacy counter. To find a retail pharmacy in the Express Scripts network please visit express-scripts.com and click “Find a Pharmacy.” You can also use the Express Scripts mobile app. Present your Trustmark/ESI member ID card and have the pharmacist process it thru your pharmacy benefit manager, ESI. If the pharmacy processes the at-home COVID-19 test kit thru ESI, you will have no copay. Please note: The pharmacy is not obligated to process your at-home COVID-19 test kit thru the ESI pharmacy program. If the pharmacy will not process the claim through your ESI prescription coverage, please see the scenario below.
- Purchase the at-home COVID-19 tests from another retailer or provider
- You purchase an at-home COVID-19 test kit and pay out-of-pocket. For example, you may order it online, purchase it along with your other grocery items or purchase them at a store that does not have a pharmacy. If this is the case, you will need to save your receipt and complete an ESI claim form for reimbursement. Please note: Your at-home COVID-19 test kit claim reimbursement will be the lesser of (1) the agreed upon contract rate with the provider per kit or (2) no more than $12 per kit.
Reminder: Each plan participant is allowed to purchase up to 8 at-home COVID-19 test kits every 30 days.
Please view this flyer for additional information.
Thank you.
FAES Insurance
301-496-8063
faesinsurance@mail.nih.gov
February 3, 2022
At-Home COVID-19 Test Kits Now Covered
As of January 15, 2022, the FAES pharmacy plan through Express Scripts will cover over-the-counter at-home COVID-19 test kits at no-cost for plan participants. Plan participants are eligible for up to 8 at-home COVID-19 test kit(s), per covered participant on the plan, from an in-network pharmacy every 30 days. You may go to any retail pharmacy in the Express Scripts network and obtain COVID-19 test kit(s) at the pharmacy counter. To find a retail pharmacy in the Express Scripts network please visit express-scripts.com and click “Find a Pharmacy.” You can also use the Express Scripts mobile app. If you are not able to obtain at-home COVID-19 test kit(s) at an in-network pharmacy, you can submit your receipt for reimbursement for up to $12 per test. Plan participants can register or login to their Express Scripts account to access a reimbursement form. This flyer has additional information.
Another method to order at-home COVID-19 test kit(s) is through the Express Scripts Pharmacy delivery service. Plan participants can register or login to their Express Scripts account to place their order.
In addition, the Federal government, with assistance from the United States Postal Service (USPS), is providing households a total of 4 tests to be delivered free of charge by request. You can learn more and order at-home COVID-19 test kit(s) by visiting www.covidtests.gov
Benefit Plan Highlight: Mental Health Resources
FAES is committed to supporting the mental health and overall well-being of our plan participants. FAES offers access to Talkspace online therapy and psychiatry, as well as Lasting (relationship support) from Talkspace at no-cost to plan participants.
Therapy can benefit everyone. It isn’t solely beneficial after experiencing a traumatic event, ongoing anxiety, or a major life change; it can help in everyday life too! A therapist may provide new techniques for problem solving, help challenge irrational habits and incorrect assumptions, reframe long-held views, or help you grow and change. A therapist can also assist you overcome mental health conditions like depression and anxiety.
Primarily a therapist can help you:
- Understand your feelings- Learn what emotions are common for a condition or circumstances.
- Get immediate support- While deep-seated issues can be addressed down the line, counseling can benefit you in situations where you need help urgently.
- Plan your future-Therapists can assist to create a game plan and set goals for the future in a safe environment and keep you accountable.
- Relieve the pressure with a therapeutic relationship- Often, simply getting things “off your chest" in a safe space can be healing. If serious problems arise again, the on-going therapeutic relationship will keep you strong.
The most important thing is that a therapist is always there for you. They’re an impartial ally who will support you without judgment.
Talkspace therapy includes 4 live video sessions per month. Talkspace psychiatry includes 13 live sessions. FAES plan participants also have access to Lasting from Talkspace (relationship support). Please view the Registration Guide on how to get started.
The Talkspace program is a supplement to the comprehensive mental health benefits offered through the current FAES medical plan. The medical plan allows plan participants to seek mental health care from both in and out-of-network providers for office visits at the same $15 copayment. Plan participants will have the same coverage for mental health office visits when going in or out of the network. There are no restrictions when selecting your mental health provider since you can go to any provider nationwide using the FAES medical plan.
Insurance Claims and Verification Info Sheet
FAES compiled an info sheet about claims processing and insurance verification. We 'hope this will be a useful tool in navigating your health insurance.
The FAES Insurance Department is here to assist you with any questions you may have. Please visit our FAQ section for common questions. If you have questions or need additional assistance, please do not hesitate to reach out to us. We are here to support you.
Thank you.
FAES Insurance
301-496-8063
faesinsurance@mail.nih.gov
2021 Archived Insurance Announcements
FAES plan participants have no-cost access to Talkspace online therapy and psychiatry and Lasting from Talkspace.
Talkspace is a digital mental health service that connects members to thousands of dedicated providers from a secure, HIPAA-compliant platform. With Talkspace therapy, you can send your therapist text, voice or video messages—anytime, anywhere—including from the comfort of your home. Talkspace also has a network of licensed prescribers specializing in mental health care and prescription management. Psychiatry appointments are only available via live video.
More information is available on the FAES “Explore Insurance Plans” page.
The Talkspace program is a supplement to the comprehensive mental health benefits offered through the current FAES medical plan. The medical plan allows plan participants to seek mental health care from both in and out-of-network providers for office visits at the same $15 copayment. Plan participants will have the same coverage for mental health office visits when going in or out of the network. There are no restrictions when selecting your mental health provider since you can go to any provider nationwide using the FAES medical plan.
FAES is committed to supporting the mental health and overall well-being of our plan participants. Starting November 1st, FAES will provide access to Talkspace online therapy and psychiatry, as well as Lasting (relationship support) from Talkspace at no-cost to plan participants. Please make sure to register using the talkspace.com/FAES website. After you register, you can start using the app. See “Getting Started with Therapy” for more information, and visit talkspace.com/FAES for FAQs and further details.
Talkspace is confidential and secure. FAES will never know who uses the service or for what purpose. Talkspace is a digital mental health service that connects members to thousands of dedicated providers from a secure, HIPAA-compliant platform. With Talkspace therapy, you can send your therapist text, voice or video messages—anytime, anywhere—including from the comfort of your home. Talkspace also has a network of licensed prescribers specializing in mental health care and prescription management. Psychiatry appointments are only available via live video.
As of Nov. 1st, FAES plan participants and their dependents, ages 13 and older, will have access to online therapy, which includes unlimited messaging and four 30-minute video appointments per month. Additionally, Talkspace psychiatry will be available to plan participants and dependents, ages 18 and over, and includes up to 13 live video sessions. Please visit talkspace.com/FAES starting November 1, 2021.
If you have any questions about Talkspace, you can reach out to the FAES Insurance Department for more information.
Note: if you are already using Talkspace with a self-pay account, contact partners-support@talkspace.com for assistance with moving your account to the FAES plan as of November 1st. You should specify if you want to continue working with your current provider.
Updated Trustmark Health Claim Form: Trustmark has updated the Medical Health Claim Form with instructions on how to fill out the form for out-of-network claim reimbursements. We have worked diligently with Trustmark in an effort to reduce the reimbursement timeframes.
Coverage while Abroad: This memorandum has information on coverage for FAES plan participants when traveling abroad
Beginning Monday June 7th, the FAES Insurance Office (Building 10, RM 1N241) will be open for appointments Monday to Thursday 10AM to 4PM. Please contact FAES by phone 301-496-8063 or email faesinsurance@mail.nih.gov to schedule an appointment.
FAES Insurance representatives will continue to be available by phone or email Monday to Friday 9AM to 4PM. We will continue to process new enrollments, renewals and terminations via email as well. For your convenience, we also continue to offer Virtual Video Health Insurance Consultations. Please email to schedule a virtual meeting.
2020 Archived Insurance Announcements
FAES new insurance plan year begins 11/1/2020. New cards are available for plan participants on mytrustmarkbenefits.com and via the myTrustmarkBenefits mobile phone app. Plan participants will receive these cards in the mail within 7-10 business days. Cards will include the new MetLife Dental and Vision information.
Plan participants can also create an account on metlife.com/mybenefits. Please enter employer name “FAES” to register.
Since 1959 the Foundation for Advanced Education in the Sciences (FAES) has been working to support the professional and educational mission of the National Institutes of Health. This support has included a health insurance program for select members of the NIH community over the past several decades. We have made many changes over the years with the end goal of ensuring a robust and sustainable plan.
We are pleased to announce the addition of robust and comprehensive dental and vision plans through MetLife effective November 1, 2020 for all FAES insurance subscribers. The new dental and vision plans will be bundled with the medical plan and Fellows will not pay for the monthly premiums. Plan details can be found in the 2020-2021 Benefit Guide.
FAES will continue to offer the Trustmark/AETNA Signature Administrators PPO plan for the 2020-2021 plan year and we are happy to announce that no coverage changes were made for the new plan year.
If you are currently enrolled and choose to remain on the medical plan for the new plan year, you will automatically be enrolled in the dental and vision plan effective November 1, 2020; you do not need to fill out new paperwork. Since this is bundled coverage in all three plans: Medical/Prescription, Dental and Vision, there is no option to opt out of any one portion of the plan.
All FAES onsite offices are closed. FAES Insurance is working remotely during our normal operating hours, Monday to Friday 9am to 4pm. We are processing all new enrollments, renewals and terminations via email. FAES is committed to continue providing excellent customer service virtually to ensure that all your health insurance needs are addressed.
FAES is covering the COVID-19 test at 100%, in and out of network, regardless of place of setting (including telemedicine visits). This will leave members with no deductible, copayment or coinsurance should they need to have this testing done. Information on COVID-19 insurance coverage in accordance with “The Families First Coronavirus Response Act”. Telemedicine Coverage: With the COVID-19 pandemic, many providers are transitioning traditional office visits to telemedicine visits. The FAES insurance plan covers in-network telemedicine visits at 100% after a $15 copayment for Primary Care and a $25 copayment for Specialist. Out-of-network telemedicine visits are covered at 70% after the out-of-network deductible. Please consult with your provider if they are capable of telemedicine visits. For any questions, please contact FAES Insurance at 301-496-8063 or faesinsurance@mail.nih.gov
All FAES Insurance members will be transitioning to a new Pharmacy Benefit Manager (PBM), Express Scripts for which you will receive a card with updated information by the third week of December (Trustmark-Medical/Express Scripts-Pharmacy) to be used beginning January 1, 2020. During the transition, any remaining refills on prescriptions should transfer automatically and CVS pharmacies will remain part of the network of locations to fill prescriptions. There will be some changes in which subscribers will need to move from a brand drug to a generic equivalent for which affected members will be notified and there will be assistance provided by the Express Scripts Member Services option in their online portal for anyone in need of help beginning January 1, 2020.
Transitioning to Express Scripts- Frequently Asked Questions
CoreSource is changing their brand name to Trustmark Health Benefits effective January 1, 2020. They are still the same company, but you will see a new Trustmark logo on all related insurance materials. The CoreSource member web portal will automatically redirect to myTrustmarkBenefits.com. This change does not affect your medical benefits, for more information on your medical coverage, please visit Benefits Guide. Beginning January 1, 2020, please show your new member ID card to your pharmacist when filling a prescription for yourself or a covered family member. You will also be able to access your pharmacy ID information anytime from your mobile device if you download the Express Scripts mobile app beginning January 1, 2020. If you have recently moved, please remember to email us your new mailing address. If you have any questions, please feel free to contact the FAES Health Insurance Department via email at FAESINSURANCE@mail.nih.gov.