Foundation for Advanced Education in the Sciences

The FAES Insurance Program is open to people who work for or at NIH in full-time (at least 32 hours per week) positions (i.e. contractors with Institute Certification, guest researchers, temporary positions, special volunteers, summer interns, and exchange scientists) who are not eligible for Government benefits. If you are unsure of whether or not you meet the above criteria, please call our office during normal business hours for further assistance. The applicant must enroll in the insurance program within the first 30 days of entrance to duty or wait until the next Open Season, which is during the month of November each year, with a January 1st effective date. The minimum participation period is three months. This period is waived if the fellow is a summer intern. FAES Health Insurance is not effective until the required enrollment forms have been completed at the FAES Business Office. To make an appointment, call: 301-496-8063. The Business Office is located in Building 10 South Side, Room B1C18. We are open Monday through Friday, 8:00 a.m. to 5:00 p.m. (also open during lunch hours).

The following categories of family members are eligible to be included if family coverage is elected by an eligible subscriber: spouse, domestic partner, legally dependent children through their twenty-sixth birthday, overage dependent children who are disabled.

Late Enrollment Exceptions: If you lose eligibility for previously held coverage, and you provide FAES with a certificate of coverage, you may be eligible to enroll past your initial thirty day period. Please contact the Business Office for more details.

Minimum Enrollment Period: You must have at least a 3-month award period* and work at least 32 hours per week. The Voluntary Dental Program enrollment period is through the end of the calendar year.

If an employee (permanent / temporary), fellow, contractor, guest researcher, summer intern, etc...separates from NIH without being enrolled in FAES' insurance program and returns to work for or at NIH within 90 days of separation they are ineligible to participate in FAES' health insurance program until the next Open Enrollment. If applicable, they may qualify for private reimbursement through their position. Contact your Administrative Officer at your institute for further information.

If an employee (permanent / temporary), fellow, contractor, guest researcher, summer intern, exchange scientist, etc...separates from NIH; terminates his/her FAES health insurance coverage without electing COBRA covereage; subsequently returns to NIH; and wants to enroll again in a FAES plan; the employee must personally pay the premiums for each month from the termination of coverage if there was less than a 90 day break from NIH. If the separation period is greater than 90 days, the employee may re-enroll into FAES' insurance program as a "new subscriber." Please contact FAES' business office for further information.

Your health insurance will be effective the date of commencement/start date or from the date of signature for electronically returned forms. Your effective date cannot precede your date of hire. All forms must be completed and received by FAES in order to complete the enrollment process. Do NOT cancel your existing insurance until you have confirmation of enrollment from FAES.

NIH Fellows [such as IRTAs, CRTAs, Summer Interns, Visiting Fellows, etc.] must bring the Election of Health Insurance form to the enrollment appointment. If you meet the eligibility requirements, and enroll within the above stated time periods, your health insurance coverage will be paid from Institute funds up to the standard allowable amount.

Non-NIH Fellows [such as Guest Researchers, Exchange Scientists, Summer Interns, Special Volunteers, contractors, temporary workers etc.] must bring a memorandum from their employer sponsor/supervisor on institute/company letter-head documenting their position, date of entrance to duty, expected duration of duty, and hours worked per week (must work at least 32 hours per week) to their enrollment appointment. Please be aware that the initial premium will be due at the time of enrollment.  Premiums are paid one month in advance (i.e. January 1 for February coverage) and there is three month minimum participation period. If working for less than three months, the entire premium must be collected at the time of enrollment.

A change from family to individual may be made if the dependent(s) have left the country, are deceased, recently divorced or separated, etc..; changing from individual to family coverage is subject to special limitations. In all cases, documentation will be required. You must report any change (e.g. marriage, birth of new baby, dependents arriving from a foreign country, loss of previous coverage) to FAES within 30 days of the event, and complete the required forms. If not reported within 30 days, then the change may be made at the next Open Enrollment Season. Please contact FAES for more information or if you are unsure whether or not you meet the above criteria.

If an individual does not enroll in the FAES insurance program when initially eligible, or wishes to make changes to coverage, or terminates his/her FAES health insurance, but remains at NIH with health insurance coverage provided through an outside company, the individual may enroll in an FAES plan during the programs annual Open Season held during the month of November. The effective date will be January 1st of the following year. A waiting period for pre-existing conditions may be applicable.

In order to avoid termination of insurance, FAES must review, and sign, your paperwork prior to the end of the renewal month. Renewal forms may be brought in, emailed to faesinsurance@mail.nih.gov, or fax their forms to the FAES Business Office (301.480.2003) by the 24th day of the month that their award is to expire. Renewal paperwork received after the 30th, will result in the termination of benefits. FAES will reinstate the coverage back to the date of termination upon receipt of the renewal form. Contact FAES for more information.

When changing from one institute to another, FAES requires timely notification of termination from the former institute, and a new Election of Health Insurance form from the new institute. If the new appointment does not start the following day after the previous award, the fellow will be responsible for providing alternate proof of insurance coverage or paying for the lapse in insurance coverage. If the fellow can demonstrate that they were outside of the U.S. during the lapse in coverage, FAES can waive this premium. Contact FAES for more information.

Unpaid Absences: For compelling circumstances, unpaid absences may be approved by the sponsor with concurrence from respective Lab/Br/Office Chief. In such cases, continuation of health insurance coverage during the unpaid absence will be required unless the period of absence exceeds 90 days. The Fellow will personally pay for coverage which starts on the first day of the month of unpaid absence. Contact FAES for more information.

The NIH will privately reimburse for outside insurance coverage, if the individual is enrolled in a private health insurance plan that meets **Institute requirements. If eligible, the Institute will issue the Election of Private Health Insurance forms to the individual. These forms should be provided to FAES for certification. In order to certify these documents for reimbursement from their Institute, FAES will need the following:

• Proof of insurance coverage (ID card, letter from vendor on letterhead etc...)
• Summary of benefits in English on company letterhead
• Coverage maximums, deductibles if applicable, and plan exclusions
• Dates of plan coverage
• The cost in U.S. dollars
• Proof of payment (credit card statement, returned check from bank, bank statement etc...)

If the insured is a J-1 Visa holder, their insurance must also include sufficient medical evacuation and repatriation coverage to satisfy their J-1 Visa requirements.

Certification of private insurance reimbursement should be brought in quarterly within the employee's award period. The employee is responsible for notifying FAES if there is a change in premium and for obtaining their Election of Private Health Insurance forms and renewal forms from their Administrative Officer.

**Institute requirements and conditions:
Application of the certified amount is at the discretion of the Administrative Officer. The insurance plan must be in the NIH employee's name or their spouse's name. If covered under the spouse, NIH will not reimburse for this coverage if the policy was already in force prior to accepting their NIH position or if the spouse's coverage is through another government agency. If upon arrival the NIH employee opts to enroll under their spouse's plan rather than FAES' insurance program, the NIH will only reimburse for the additional cost incurred by the spouse to add them to their coverage. Please be aware that if adding the spouse to their plan does not result in a premium change, the NIH will not pay for that policy.

All Fellows will need to provide a "Notification of Termination" to FAES prior to their departure. The form may be hand carried to Building 10, South Side, Room B1C18 or faxed to 301.480.2003, or emailed to faesinsurance@mail.nih.gov. Once received, the coverage will be terminated at the end of the month the fellow is leaving. A third party will send info on how to continue coverage to the address left on file.

Your health insurance will be effective the date of commencement/start date and all forms are completed by both parties. As we cannot guarantee immediate availability of appointments, you should not cancel your travelers insurance until you have met with FAES. If you have purchased private insurance, sufficient proof of coverage must be provided. FAES will need a policy summary on company letterhead that is written in English. Per J-1 Visa requirements, it must define coverage maximums of no less than $50,000 per incident, deductibles of no more than $500, cover medical evacuation and repatriation of no less than $17,500. FAES will also need the dates of the period of coverage and the cost of the policy amount in U.S. Dollars.

The J-1 form must be endorsed by FAES personnel in order for it to be valid. If the policy does not meet the minimum requirements of the J1-VISA exchange program, FAES has the right to not endorse the policy. Recommendations will be made on how to satisfy the missing requirements.

In addition, if you have private health insurance that does not contain the required amount of Medical Evacuation and Repatriation of Remains, you may purchase a separate policy through FAES. Contact your Fogarty Immigration Specialist or FAES for more information.

Appointments are available on a first come first served basis. After a Fellow has arrived and after the fellow has met with the Division of International Services (if applicable), please have the Fellow contact our office (301)496-8063 for an appointment. Insurance coverage is effective as of the date of commencement/start date and all forms are completed by both parties. Please notify Fellows NOT to cancel existing insurance until they have met with FAES.

Election of Health Insurance Through FAES (Choice 1): This form is for use when the Institute will be paying FAES for the health insurance premium. Dates on the form must not exceed one calendar year. If the fellowship is for more than 365 days, a renewal election form will need to be prepared one month prior to the expiration of the previous form.

Election of Health Insurance for a Private Company (Choice 2): If a fellow does not opt to participate in the FAES insurance program, they may be reimbursed for their privately held coverage via this form. Please refer to the Private Insurance Reimbursement section for details. In either case, your copy of the election form will be returned to your office via inter-office mail. Please be sure to put your 'return to' [name, bldg/rm] information on the form. If the fellow's insurance is being funded through any other mechanism, or if they are responsible for their own premiums, please do not issue a form. Please see the paragraph referring to documentation for cash participants.

Termination: When a Fellow leaves the sponsoring institute, please make sure that FAES receives the fellow's Notification of Termination prior to their departure. Forms may be brought in, emailed to faesinsurance@mail.nih.gov, or fax their forms to the FAES Business Office (301.480.2003). If a fellow is transferring to another institute, please check off "change" box on the Notification of Termination form to avoid unnecessary termination of coverage. Please have the fellow bring FAES their new Election of Health Insurance forms from their new institute with the Termination Notification. For additional information, please contact FAES, 301-496-8063.