Medical Insurance: Medical Insurance Plan (MIP) | United Nations Development Programme

1	Step Flowchart - MIP process	Responsible Party	Template/Guideline Flowchart - MIP process	Explanatory Notes
2	Step Enrollment of staff: MIP 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 MIP Application/ Request for Change Form	Explanatory Notes Education of staff about MIP 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 for MIP purposes, the same rules procedures for UNDP staff must be followed
3	Step Enrollment of staff: Staff member and eligible dependents (where relevant) are enrolled in MIP in Quantum.	Responsible Party	Template/Guideline	Explanatory Notes In addition to ensuring the correct payroll calculation of these elements, the data entry process is also critical for reporting purposes and for the timely and accurate payments of MIP reimbursement claims
4	Step Managing eligibility data in Global Payroll: Data on enrollment form is verified and validated and any change in coverage is processed into Quantum promptly	Responsible Party	Template/Guideline	Explanatory Notes
5	Step Eligibility Data: Reviews and validates eligibility data in the system and transmits file to claims administrative company	Responsible Party MIP HR Technical Support	Template/Guideline	Explanatory Notes A technical interface uploads enrollment and eligibility data from Quantum and the claims administration company (TPA)
6	Step ID Cards: Uploads eligibility data; issues ID cards; and communicates exceptions, if any, to HR Technical support	Responsible Party	Template/Guideline	Explanatory Notes
7	Step Claims: MIP claims are submitted through the online Claiming tool in a sealed envelope containing the MIP Refund Claim form and supporting documents directly to the company that administers MIP, following the instructions on the claim form	Responsible Party Staff member	Template/Guideline MIP Refund Claim form	Explanatory Notes Effective January 2004, UNDP outsourced the administration of MIP claims to an independent administration brokerage company. The TPA company is responsible for administering MIP claims and for ensuring compliance by subscribers with the MIP rules and avoiding unreasonable or abusive use of the plan.
8	Step Reimbursement of claims: Claims are verified and processed as follows: - If the claim fully meets requirements, a payment instruction is processed through interface between the TPA and UNDP and a Statement of Benefits is sent to the staff member - If the claim does not meet requirements, a notification and/or request for further information/documentation is sent to the staff member	Responsible Party Claims Administration Company	Template/Guideline P-2 Form Designation of Beneficiaries	Explanatory Notes Payment of claims is made through an interface between the claims administration company and Quantum. Payment that goes through this interface will not indicate the nature of the medical services provided. 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. Patient confidentiality will be protected as any MIP.
9	Step Payments: The payment instruction file received from the MIP Administration Company (TPA) is uploaded into system and an instruction is sent to UNDP to effect payment	Responsible Party MIP HR Technical Support	Template/Guideline	Explanatory Notes
10	Step Payments: Vouchers are uploaded, payments are processed and staff member is notified	Responsible Party	Template/Guideline	Explanatory Notes In order to effect prompt and timely payment, staff member must be properly set up as a vendor in Quantum