Dental Insurance: UN NY Cigna Dental Plan | United Nations Development Programme

1	Steps Flowchart	Responsible Party OHR Copenhagen	Template/Guideline Flowchart - Dental Insurance: UN NY Cigna Dental Plan HR_Insurance Plans_Cigna Dental Insurance Flowchart Download	Explanatory Notes
2	Steps Enrollment of staff: Application/Request for Change Form completed and submitted together with supporting documents in respect of staff member’s participation, including his/her eligible family members, where relevant	Responsible Party Staff member	Template/Guideline Cigna Dental	Explanatory Notes Staff members who have no insurance coverage under a United Nations plan or through a family member must be strongly urged to obtain medical insurance coverage for themselves and their eligible family members, as the cost of medical care can result in financial hardship for individuals who fall ill and/or injured and have no coverage If staff member or eligible family members are not enrolled within 31 days after an event that gives rise to an entitlement for coverage, an application for coverage may be submitted during the annual enrollment campaign. See: https://www.un.org/insurance/. In the case of a staff member married to another staff member, the insurance coverage, whether at the two-person or family level, must be carried by the higher salaried staff member Education of staff about the provisions under the insurance plan and distribution of materials by the person most familiar with the scheme is absolutely necessary If an office administers personnel on behalf of another agency, the same rules procedures for UNDP staff must be followed.
3	Steps Enrollment of staff: The completed application for enrollment form is certified and submitted to Insurance and Disbursement Services within 31 days of eligibility for the entitlement	Responsible Party OHR Copenhagen, BES-GSSC	Template/Guideline	Explanatory Notes The administration of this category of employees is centralized in the Benefits & Entitlements Services Unit in BES-GSSC in Copenhagen The UN Health and Insurance Unit administers the workflow of enrollment and reporting directly with the insurance carrier on behalf of UNDP
4	Steps Enrollment of staff: Staff member records in ATLAS are validated, contributions are computed and coverage is activated	Responsible Party UN Health and Life Insurance Unit	Template/Guideline	Explanatory Notes
5	Steps Managing eligibility data in ATLAS: Data on enrollment form is verified and validated and any change in coverage is processed into ATLAS promptly	Responsible Party , UN Insurance Unit	Template/Guideline	Explanatory Notes
6	Steps Issue ID card: Identity cards are issued to the staff member and eligible dependent(s)	Responsible Party	Template/Guideline	Explanatory Notes It is the responsibility of the staff member to ensure that the correct mailing address is submitted. Incomplete or incorrect mailing addresses in ATLAS will result in misdirected mail or failure to receive important Information
7	Steps Claims: Insurance claims are submitted, in a sealed envelope together with supporting documents, on a claim form directly to the insurance carrier, following the instructions on the claim form	Responsible Party Staff member	Template/Guideline	Explanatory Notes Subscribers should note that claims for reimbursement must be submitted to the insurance carrier no later than two years from the date on which the medical expense was incurred. Claims received later than two years after the date on which the expense was incurred will not be eligible for reimbursement The administration and management of the health insurance plans for internationally recruited staff governed by the UN Staff Regulations and Staff Rules are administered by the UN Health and Life Insurance Unit. Any questions/queries on the provisions under the plan or any disputes regarding claims must be submitted directly to this unit, located at 304 East 45th Street, 3rd Floor or contact at: hlis@un.org.
8	Steps Verification and reimbursement of claims: Insurance carrier reimburses staff member directly	Responsible Party	Template/Guideline P-2 Form Designation of Beneficiaries HR_Insurance Plans_Designation, Change or Revocation of Beneficiary Form P-2 Download	Explanatory Notes Payment is made to the insured person, but, if the subscriber is no longer alive, payment will be made to his/her beneficiary as per P-2 Form Designation of Beneficiaries
9	Steps Request a review if a claim is denied: A claim denied in whole or in part must be submitted to the insurance carrier. The insurance carrier will provide the subscriber with a written notice explaining the reason for the denial and the appeal procedure	Responsible Party Staff member,	Template/Guideline	Explanatory Notes The request for review must be submitted in writing within 60 days of receipt of the notice. The subscriber should include the reasons for requesting the review and submit the request to the insurance carrier. The insurance carrier will review the claim and ordinarily notify the subscriber of its final decision within 60 days of receipt of the request. If special circumstances require an extension of time, notification will be given to that effect.