UN retirees: Where to turn for assistance with after-service health insurance? September 8, 2026

There is something striking about the September 4 letter from the FAFICS President to association heads that I came across on the AFICS/NY website today.

The questions that UN retirees raised in their letters last month to the FAFICS President went beyond the mechanics of individual health insurance claims. We asked about cost containment, independent auditing, the basis for the premium increases, and the late communication of the changes. (See link to my "Reality Check" post below).

The President’s letter to the association heads focuses primarily on what retirees should do when they have a problem with a claim or an unanswered inquiry. That’s useful information. But it raises an important question:

Why is it that when we asked questions about how the health insurance system itself operates, who oversees it, how costs are controlled, whether decisions are independently scrutinized, and whether retirees have an effective voice in those decisions, we get an answer primarily about how to navigate the claims process?

Still, it’s a useful topic and I’m taking the opportunity to provide some detailed information about the process, as the FAFICS President outlines, add some information about resources that may be of assistance to UN retirees, and highlight some gaps that may need to be addressed.

According to the September 4 letter, the official pathway is:

1. Take a rejected claim or unanswered inquiry to your plan's claims administrator.

2. If the problem remains unresolved, take it to the health-insurance unit of your former organization.

3. If it still isn't resolved, take it to your local AFICS association, which can then escalate generic, system-wide issues to FAFICS.

The President’s letter notes: “We cannot take up individual cases across our 65 Associations, but every case you share sharpens our advocacy. You and your members are not facing this alone. I invite every Association to send us your generic questions and concerns at any time.”

Here are the official steps regarding claims:

1. Start with the claims administrator

The UN's current retiree guidance directs participants to the relevant third-party administrator for questions about claim processes, ID cards and related matters. For UN Headquarters-administered plans, the administrator contact is specific to each plan: Here's the information as per the HLIS ASHI website: 

https://www.un.org/insurance/content/retirees  

The important thing to understand is that the claims administrator is an administrator, not an independent advocate for the retiree. If your claim is denied, you are using the plan's own claims and appeals machinery to challenge that decision. 

2. Then comes HLIS

If the issue cannot be resolved with the claims administrator, FAFICS directs retirees to the health-insurance unit of their former organization. For UN Headquarters retirees, that means the Health and Life Insurance Section, HLIS. The current HLIS retiree contacts are:

917-367-9727

ashi@un.org

HLIS also provides client service at its New York office during designated hours. HLIS handles questions concerning enrollment, maintenance and changes to UNHQ-administered health-insurance plans and provides policy or technical support. But it is part of the UN administrative structure. It is not an independent advocate whose role is to represent the retiree against that structure.

AFICS associations

The FAFICS president then directs UN retirees to their local AFICS association when a problem remains unresolved. Remember, however, that the vast majority of UN retirees worldwide are not members of an AFICS association.

I just saw that the AFICS/NY After-Service Health Insurance page on its website, for example, states: “AFICS/NY helps you navigate After-Service Health Insurance (ASHI) and Dental Insurance (ADI) with confidence. From policy updates to enrollment guidance, we provide the information and advocacy you need to manage your benefits clearly and effectively.”

The general telephone number and email address for AFICS/NY are:

212-963-2943

afics@un.org

At the end of the health insurance page,“Still have questions” leads to  a “contact us” link. I can’t say what happens after a UN retiree contacts AFICS/NY or any other local AFICS association seeking advocacy on after-service life insurance. It likely depends on the association, its resources and its willingness and ability to intervene.

https://www.aficsny.org/services-ashi-medicare

Here’s the list of local AFICS associations with contact info posted on the FAFICS website:

https://fafics.org/member-associations/list/

A simple test 

I suggest a simple test for UN retirees who need assistance: reach out and see what happens. In the case of AFICS/NY, and indeed any of the FAFICS member associations, retirees should be able to find out not only what information is available, but what the association is prepared and able to do when an individual needs help resolving an after-service health insurance problem. This seems particularly reasonable given that FAFICS and its member associations present themselves as representing UN retirees generally, not only those who pay membership dues. If that is the claim, then retirees, members or not, should be able to expect meaningful assistance when they need it.

4. What about the UN Ombudsman?

There may be another possible resource, for guidance, not advocacy: the UN Ombudsman and Mediation Services. The Ombudsman serves current and former employees of the UN Secretariat, including retirees, and provides confidential assistance in exploring options and navigating difficult situations.

Contact:

unoms@un.org
917-367-5731

But it is important not to misunderstand its role. The Ombudsman is not a health-insurance appeals body and does not decide claims. Its role is to help people understand their options and navigate difficult situations. It may nevertheless be useful when someone feels stuck and needs help figuring out how to proceed.

5. Independent resources

For retirees in the United States, independent organizations can sometimes help with aspects of health-insurance problems, particularly Medicare.

The Medicare Rights Center provides assistance with Medicare benefits, denials and appeals and operates a national helpline at 800-333-4114.

In New York City, HIICAP, the Health Insurance Information, Counseling and Assistance Program, provides free Medicare counseling through NYC Aging at 212-244-6469.

These resources are obviously limited to Medicare-related issues. Retirees elsewhere may want to investigate comparable independent health-insurance or patient-advocacy services in their own countries.

So where is the gap?

Official pathway:

Claims administrator → former organization/HLIS → local AFICS → FAFICS for generic, system-wide issues

There are two gaps we need to recognize:

It's important to note that none of the above is the same as having an independent advocate whose job is to take up an individual retiree's case. Second, the claims pathway does nothing to answer the broader questions retirees raised about cost containment, independent oversight, auditing, transparency and decision-making.

What might we eventually need? If these gaps persist, there are several possibilities we may eventually need to consider.

First, FAFICS by UN retirees, and UN staff unions by staff, could be pressed to establish a clearer and more accessible mechanism for individual health-insurance advocacy, rather than leaving retirees (and staff) to navigate the system largely on their own.

Second, the UN could be asked to establish an independent health-insurance ombudsman or participant advocate with a genuine mandate to assist retirees (and staff) with individual cases while also identifying recurring systemic problems.

Third, if neither approach proves possible, retirees (and staff) may eventually need to consider whether another mechanism for independent representation is necessary.

Those are possibilities, not a call to action today. For now, I think it is useful simply to be encouraged that our collective action can have an impact; understand what the system says you should do; what each entity can actually do; and where the gaps are. I'm putting these issues out there for comment and discussion, with a view to possible future action. I welcome your thoughts and perspectives.

https://www.aficsny.org/post/4-september-2026-letter-from-fafics-president-changes-to-unhq-administered-health-insurance-plan

https://unpension.blogspot.com/2026/08/a-reality-check-on-fafics-un-retirees.html

Update: UN Pension and After-Service Health Insurance. We have their attention, if not the answers we asked for. September 8, 2026

On August 4, I published a post on the UN Pension Blog asking some uncomfortable questions about FAFICS (the Federation of Associations of Former International Civil Servants) representation of UN retirees, and whether our interests are actually being defended on issues that matter enormously to us, specifically pension and after-service health insurance.

In Facebook posts and circulated emails, on 7 and 20 August, I asked UN retirees to join me in writing to FAFICS on the topics of pension and health insurance, and to HLIS (the UN Health and Life Insurance Section) on health insurance. My blog article and suggested emails focused on questions of accountability and representation regarding FAFICS, and also made suggestions about actions UN retirees could take with their local FAFICS association.

I have received no response to my own emails to the FAFICS president or to HLIS. I don’t know whether other retirees have received responses. Today, it came to my attention that there are two letters from the FAFICS President, dated August 31 and September 4, apparently addressed to the heads of local AFICS associations, posted on the AFICS/NY website, to which we should pay attention.

Are we having an impact?

As noted, the FAFICS President’s letters are addressed to its association heads. They are not addressed to association members, and are not necessarily in response to UN retirees’ collective writing campaign. Let’s just say that the timing is interesting.

The August 31 letter is significant because the President is explicitly asking member association heads to send him their concerns, ideas and suggestions about what FAFICS should address at the next Council Session in Geneva. Significantly, he asks how FAFICS can become more responsive to the needs and expectations of its members and how the concerns of retirees can better shape its work.

The September 4 letter goes further. It acknowledges that many retirees have written to their associations and to the FAFICS President directly about the changes to the UN Headquarters-administered health-insurance plans. He says that their concerns are legitimate and sets out what FAFICS says it is doing in response.

However, while there’s some recognition that UN retirees are raising concerns, it’s also notable that the letters contain no specific answers to our questions. In other words, there’s no evidence that the President has taken those concerns on board or that they’ll be addressed.

It’s important to note that FAFICS has a long history of making statements about its advocacy and commitment to retirees. The gap between words and effective, transparent and sustained action has always been the issue. 

It's also important to note that the Council Session is scheduled for almost a year from now: July 2027. 

Health insurance: some answers, but not the answers we asked for

The FAFICS President’s letter dated September 4 describes a number of things FAFICS says it has done, as follows:

It has advocated with senior UN management for stronger funding arrangements, full voting representation for retirees on health-insurance committees, “better-value coverage” and an opportunity for the FAFICS President to address the High-Level Committee on Management on retirees' concerns. It also reports that FAFICS surveyed more than 2,400 retirees from 48 associations about claims processing, appeals and long-term-care awareness and developed seven recommendations from that work.

He doesn’t inform the association heads what the seven recommendations gleaned from the survey are, or what FAFICS’ interventions may have achieved. Most important, the letter does not address the questions raised in the letters UN retirees sent last week concerning cost containment, independent auditing and the late communication of the changes.

So while it’s encouraging that the President wants to take retirees’ concerns to the High-Level Committee on Management, we don’t know what concerns he’s taking, or whether our stated concerns are included.

Pension

Here’s something else that’s not very encouraging. There’s little mention of pension in either of the President’s letters, except that next year’s Council Session will provide an opportunity to interact with Pension Board officials and “gain a better understanding of developments affection our pensions and the broader interests of retirees, including ASHI.”

As you know, the General Assembly has called for the Pension Board to undertake a broad review of the UN pension scheme, including its design and ways of lowering costs and contributions that may have enormous consequences for current and future retirees.

The questions we raised with FAFICS in our 20 August letter include the implications of moving away from the existing defined-benefit structure, the protection of accrued rights, and whether COLA is regarded as an integral part of those rights. We also asked about the stated “quick wins” including pension reform that the US government has stated (Devex article in April 2026) it wishes to achieve.

It’s important for UN retirees to know not just what FAFICS says about pension reform, but what it actually does to defend the existing system and accrued rights. The President’s January letter to the heads of FAFICS associations was not reassuring.

Who does FAFICS represent?

FAFICS describes itself as the unified, system-wide voice of all UN retirees and says it raises issues that individual associations cannot address alone. As I noted in my “FAFICS reality check” article, there are legitimate questions concerning consultation, accountability and transparency regarding FAFICS. Given that so far there has been no genuine system of consultation between FAFICS, its member associations, and the associations’ members, is it even worth raising the issue of consultation of UN retirees who are not members of an AFICS association?

It appears that the FAFICS President is attempting with his 31 August letter to association heads to address some of these issues, and that’s encouraging.

What have we learned?

I believe the most important development of the past month of UN retirees’ letter-writing campaign is that it appears we can make ourselves heard. The FAFICS President’s August 31 and September 4 letters indicate that we have the attention of the FAFICS leadership even if our questions are not being addressed. It’s a start.

What’s next?

The August 31 letter says a small working group has been set up, led by the FAFICS Vice President and the Secretary to design the programme for the 57^th Council Session, and input from the association heads is requested by 25 September 2026, via a Google form link. 

I believe the least we can expect is that he’ll forward the content of our recent letters to his colleagues who are preparing next year’s meeting. 

But, again, the FAFIC’s 57^th Council session takes place almost a year from now. 

So our primary question should be:  What action can we expect the FAFICS president, who is also the president of AFICS/NY the last time I checked, to take in the meantime on the important issues of pension and after-service health insurance that we’ve raised? 

If you haven’t already done so, please send the emails and take the other actions suggested in my “Reality Check” post (link below) to the FAFICS president and copy the local AFICS association. See also a list and contact numbers below for local associations.

For now, I think we should be encouraged that our collective voices may have had an impact; see if answers are forthcoming to the questions we've asked; continue raising our concerns, and hold accountable the organizations that say they speak in our name. I welcome your thoughts and perspectives.

https://www.aficsny.org/post/letter-from-fafics-president    

https://fafics.org/member-associations/list/. 

https://unpension.blogspot.com/2026/08/a-reality-check-on-fafics-un-retirees.html

UN retirees: Updated call to action on pension and health insurance, September 3, 2026

 Dear UN retirees,

Further to my earlier post regarding UN pension and After-Service Health Insurance (ASHI), I am writing to ask you to take action on both issues.

Even if you have already sent emails to FAFICS or HLIS in response to my earlier posts, please send these new emails as well. The new information about continuing increases in health-care costs together with the documented need for independent auditing and verification of health-insurance costs and cost-containment measures, makes these new communications necessary, and they state that they supersede any previous communications on these matters.  

There is a new reason for urgency.

A New York Times report today, “Employer Health Costs Are Expected to Spike in 2027,” reports that employer-sponsored health-care costs are projected to rise by an average of 11% in 2027, assuming no changes to health plans. Employers can reduce their costs by changing their plans, but such changes can shift more costs to workers or reduce their benefits. The article describes the resulting 8% increase in employers’ final costs as the steepest since 2003, underscoring the continuing pressure of rising health-care costs on health-insurance participants.

https://www.nytimes.com/2026/09/02/business/health-insurance-increases.html

For UN retirees, this should raise a fundamental question: if health-care costs are going to continue rising, who is independently verifying that the costs being passed on to participants are reasonable, and that measures described as “cost containment” are actually producing the savings claimed?

This is not simply a question of whether health care is becoming more expensive. It is a question of independent oversight and accountability.

The UN's own record makes this particularly important. The Board of Auditors raised concerns about inadequate controls and reported in 2019 that the last audit of actual medical claims had been conducted in 2010. An “open-book” audit was subsequently undertaken in 2022, but its findings do not appear to have been made public. The JIU's 2023 review found that most UN health-insurance schemes were not regularly audited and that cost-containment measures generally could not demonstrate the savings achieved.

There is a second issue: pension.

The General Assembly has mandated a broad review of the UN pension scheme, including its design and ways of lowering costs and contributions. Possible changes could include a hybrid defined-benefit/defined-contribution system, making it important that accrued rights and the integrity of the present defined-benefit system be protected.

There is also an important political context. An April 2026 Devex report identified UN pension reform as one of the “quick wins” the U.S. government intended to seek from the UN in connection with payment of U.S. UN dues. I have written about what this external pressure, together with the current pension review, could mean for the Fund in my UN Pension Blog essay, “Quick Wins and Slow Erosion.”

That is why I am encouraging retirees to take two simple actions:

1. Write to FAFICS and ask what it is doing to protect retirees' interests on both pension and ASHI, including whether it has raised the issues of timely communication, independent health-insurance oversight and verification of cost-containment savings.

2. Write to HLIS and ask about its role in premium-setting and cost containment, how those measures and their claimed savings are independently verified, and what is being done to ensure that retirees receive important information before, rather than after, an enrollment period.

Again, even if you have already written, please send the updated letter. This new communication supersedes the previous one.

These are not matters we should simply read about and move on from. Our collective voice is much stronger than any individual voice, but only if we use it.

Thank you for taking the time to speak up on issues that affect us all.

Please read the relevant UN Pension blog articles at the end of this post,including about the outdated Avaaz petition that went viral earlier this month; details of the changes to ASHI plans; and a "Reality Check on FAFICS: who do they represent?" Note that this article contains important questions on these issues that UN retirees should ask the heads of local FAFICS associations; and please regularly consult the UN Pension Blog for updates:

https://unpension.blogspot.com

Thank you.

Loraine Rickard-Martin

Suggested email to FAFICS

President@fafics.org, Secretary@fafics.org, 

cc. Afics@un.org (NY-based retirees) or your local FAFICS association

Subject: Protecting the interests of UN retirees: pension and after-service health insurance

Dear President Shah,

I am writing as a UN retiree concerned about whether our interests are being adequately represented on two issues fundamental to our long-term security: our pension and After-Service Health Insurance (ASHI).

Even if I have previously communicated with FAFICS about these issues, I am sending this letter because important new information has emerged concerning the continuing rise in health-care costs and the need for independent auditing and verification of the UN's self-funded health-insurance plans. This letter therefore supersedes any previous communication I may have sent on these matters.

The urgency of the ASHI issue has been underscored by today's New York Times report, “Employer Health Costs Are Expected to Spike in 2027.” The report projects that employer health-care costs will rise sharply again next year, reinforcing the concern that rising health-care costs are likely to remain a continuing pressure on participants.

https://www.nytimes.com/2026/09/02/business/health-insurance-increases.html

For UN retirees, this raises a fundamental question: if health-care costs are expected to continue rising, what independent assurance do we have that the costs underlying our self-funded health plans are being adequately scrutinized and that measures described as cost containment are actually producing the savings claimed?

I would appreciate a clear response on what FAFICS is doing to safeguard retirees' interests, particularly on the following:

Pension: What position is FAFICS taking on the General Assembly's mandated pension review, including possible changes in pension design and proposals to lower costs or contributions? What safeguards does FAFICS believe are necessary to protect accrued pension rights and the integrity of the existing defined-benefit system? Does FAFICS regard COLA as an integral component of accrued pension rights?

The broader political context also warrants attention. An April 2026 Devex report identified UN pension reform as one of the “quick wins” the U.S. government intended to seek from the UN in connection with payment of U.S. UN dues. What position is FAFICS taking regarding this external pressure for pension reform and cost reduction?

ASHI: What concerns or recommendations has FAFICS conveyed to the UN Administration regarding the affordability and sustainability of ASHI, including this year's significant premium increases?

The need for independent oversight is particularly important. The Board of Auditors raised concerns about inadequate controls and reported in 2019 that the last audit of actual medical claims had been conducted in 2010 (A/74/5 (Vol. I)).An “open-book” audit was subsequently undertaken in 2022, but its findings do not appear to have been made public. The JIU's 2023 review (JIU/REP/2023/9) found that most UN health-insurance schemes were not regularly audited and that cost-containment measures generally could not demonstrate the savings achieved.

These findings are difficult to reconcile with continuing substantial increases in premiums and the repeated emphasis on cost containment.

What independent assurance exists that the costs underlying the UN's health-insurance plans are being adequately scrutinized and that the cost-containment measures relied upon by the Administration are actually producing the savings claimed?

There is also the question of timely communication. The 1 May town hall did not include information about this year's premium increases because the new premiums had not yet been finalized, and many retirees were not aware that the town hall was taking place. Information about the premium increases was subsequently provided after the June 2026 enrollment period, leaving retirees without timely information that could have enabled them to consider whether to change plans.

Did FAFICS raise concerns about this lack of timely communication and about whether retirees were given a meaningful opportunity to make informed choices during the enrollment period?

Finally, FAFICS presents itself as representing the interests of UN retirees. How does FAFICS consult its affiliated associations in developing its positions, and how does it ensure that the interests of retirees who are not members of those associations are also taken into account?

These issues are too important for retirees simply to assume that our interests are being adequately safeguarded. We need to know what FAFICS is advocating, what positions it is taking, what safeguards it considers necessary, and how it intends to defend retirees' interests throughout the pension review and in decisions affecting ASHI.

I would therefore appreciate a substantive response to these questions.

Sincerely,

[Name]

UN retiree

Suggested email to HLIS

HLIS@un.org, cc ASHI@un.org, cc Afics@un.org, (NY-based retirees) or your local FAFICS association 

NY-based UN retirees: cc Afics@un.org. UN retirees based elsewhere, please copy the head of the local Fafics association.

Subject: After-Service Health Insurance: rising costs, independent oversight and timely information

Dear Head of HLIS,

I am writing as a UN retiree concerned about this year's ASHI premium increases and, more broadly, about how decisions affecting retirees are justified, independently overseen and communicated.

Even if I have previously communicated with HLIS about ASHI, I am sending this letter because important new information has emerged concerning the continuing rise in health-care costs and the need for independent auditing and verification of the costs underlying the UN's self-funded health-insurance plans. This letter therefore supersedes any previous communication I may have sent on these matters.

Today's New York Times report, “Employer Health Costs Are Expected to Spike in 2027,” makes this issue particularly timely. The report projects that employer health-care costs will rise sharply again next year, reinforcing the concern that rising health-care costs are likely to remain a significant and continuing pressure on participants.

https://www.nytimes.com/2026/09/02/business/health-insurance-increases.html

That makes independent scrutiny of those costs and of the effectiveness of cost-containment measures increasingly important.

I appreciate HLIS's explanation that this year's increases reflect rising health-care costs, utilization, specialty medications and other factors, and that the Health Insurance Committee considers claims experience, utilization, reserves and other information when making recommendations.

But two fundamental questions remain.

First, what is HLIS's role in developing and reviewing premiums, and to what extent can it recommend or advocate measures to contain costs? More importantly, how are the effectiveness and claimed savings of those cost-containment measures independently assessed and verified?

This question is particularly important given the history of oversight of the UN's self-funded health-insurance plans.

The Board of Auditors reported in 2019 that the last audit of actual medical claims had been conducted in 2010 (A/74/5 (Vol. I)). An “open-book” audit was subsequently undertaken in 2022, but its findings do not appear to have been made public. More recently, the JIU's 2023 review (JIU/REP/2023/9) found that most UN health-insurance schemes were not regularly audited and that cost-containment measures generally could not demonstrate the savings achieved.

These are significant findings.

If the plans are self-funded and participants are being asked to pay substantially higher premiums because costs must be contained, there should be clear, independent assurance that the costs are properly scrutinized and that measures presented as cost-saving actually deliver the savings claimed.

Please explain what independent audit or verification mechanisms currently exist, who conducts them, how often they are undertaken, and whether their findings are made available to participants.

Second, what is HLIS doing to ensure that all ASHI participants receive timely and clear information before significant changes take effect?

This year's experience raises particular concerns. The 1 May town hall did not include information about the premium increases, since the new premiums had not yet been finalized, and many retirees were not aware that the town hall was taking place. Information about the premium increases was subsequently provided after the June 2026 enrollment period.

As a result, retirees did not have timely information about the increases and therefore did not have a meaningful opportunity during the enrollment period to consider whether changing plans might be appropriate.

What steps is HLIS taking to ensure that retirees receive important information about changes to premiums and benefits before, rather than after, the enrollment period in which they may need to make decisions?

Finally, given the likelihood that health-care costs will continue to rise, what longer-term measures are being considered to protect the sustainability and affordability of ASHI without simply transferring an increasing share of the costs to retirees?

I would appreciate a substantive response to these questions, particularly concerning independent auditing and verification of health-care costs and the effectiveness of cost-containment measures.

Thank you for your attention to these concerns.

Best regards,

[Name]

UN retiree

Relevant articles:

https://unpension.blogspot.com/2026/05/quick-wins-and-slow-erosion-whats-at.html

https://unpension.blogspot.com/2026/08/a-reality-check-on-fafics-un-retirees.html 

https://unpension.blogspot.com/2026/08/un-health-insurance-whats-changing-in.html

https://unpension.blogspot.com/2026/08/un-pension-fund-members-avaaz-petition.html

 

 

 

UN Pension Fund members: Avaaz petition is from 15 March 2022. It is moot! 15 August 2026

 UN Pension Fund Members,

If you have received an Avaaz petition titled "Secretary-General Antonio Guterres: Don't hand our UN pension fund to Wall Street", see below message from Ian Richards, Vice President, Conditions of Service, CCISUA, dated 14 August 2026. Please disregard the petition. 

"Ian Richards

LINKEDIN 

• 1st

Helping governments use digital and AI

14 August 2026 • Edited • 

 Some of you will have seen this petition about the UN pension fund outsourcing investments

While it has gone viral in recent days, it dates from 2022 and the matter is now fortunately settled. 

The petition was launched by the Coordinating Committee for International Staff Unions and Associations (CCISUA) in response to plans announced at the time to externalise the management of up to 75 percent of the fund’s fixed income portfolio.

Following the petition, a staff townhall and a number of letters from CCISUA, the fund reconsidered its position. As a result of this staff mobilisation less than 20 percent is currently outsourced.

Therefore if you receive the petition you can disregard it; the issue is moot."

UN Health Insurance: What's Changing in 2026, 7 August 2026

UN Health Insurance Changes Effective 1 July 2026 - and analysis of information presented in the HLIS webinar, 21 May 2026

By Loraine Rickard-Martin

Summary by AI. Participants are advised to check the actual documents.  

 The UN's 2026 health insurance changes are set out in two separate Information Circulars.

ST/IC/2026/2 covers five Headquarters-administered health plans:

• Aetna PPO/POS
• Anthem PPO
• HIP Health Plan of New York
• UN Worldwide Plan
• Cigna US Dental PPO

ST/IC/2026/3 covers the separate Medical Insurance Plan (MIP) for locally recruited staff at designated duty stations away from Headquarters. The MIP has three regional versions, administered by Cigna.

Both sets of changes took effect 1 July 2026.

For retirees, the Headquarters-administered plans, particularly the UN Worldwide Plan, Aetna and Anthem, are the most relevant.

---

1. UN Worldwide Plan

The UN Worldwide Plan (WWP) is one of the five Headquarters-administered plans covered by ST/IC/2026/2.

What changed?

Change	Effect on participant
Premium +15%	🔴 Pay more
Physical therapy: 60 → 30 visits/year	🔴 Less coverage
Annual-limit benefits excluded from Major Medical	🔴 Less protection against very high expenses
Out-of-pocket threshold: $200 → $600 per person; $600 → $1,800 per family	🔴 Pay substantially more before additional protection begins
Second surgical opinions: 100% → 80%	🔴 Pay more
Private rooms covered only when medically necessary	🔴 More restricted coverage
Fertility treatment: 6 IUI + 6 IVF lifetime	🔴 New lifetime limits
Annual check-up restricted to essential screenings	🔴 Narrower coverage
Nursing care clarified: up to 8 hours/day for first 30 days, then 4 hours/day	🟢 Clearer coverage

Bottom line

The biggest changes for Worldwide Plan participants are the 15% premium increase, much higher out-of-pocket threshold, reduced physical therapy, and weaker Major Medical protection.

The nursing-care provision is the principal positive change.

The UN also states that the Worldwide Plan is not designed to provide adequate coverage for the high cost of healthcare in the United States. Participants who live in the United States or expect to receive regular care there should therefore consider whether a U.S.-based plan is more appropriate.

---

2. Aetna PPO/POS

What changed?

Change	Effect on participant
Premium +35%	🔴 Pay substantially more
No specific new benefit reductions identified in ST/IC/2026/2	— The circular does not identify major new coverage reductions for Aetna

The 35% premium increase is the largest among the five Headquarters-administered plans.

The circular does not identify specific new benefit reductions for Aetna comparable to those announced for Anthem and the Worldwide Plan.

Bottom line

Aetna participants face a 35% premium increase, with no specific new benefit reductions identified in the circular.

---

3. Anthem PPO

What changed?

Change	Effect on participant
Premium +16%	🔴 Pay more
Physical therapy: 60 → 30 visits/year	🔴 Less coverage
Annual out-of-network deductible for covered care outside the U.S. waived	🟢 Potentially more favorable for participants receiving care outside the U.S.

The reduction in physical-therapy visits is the principal negative benefit change.

The waiver of the annual out-of-network deductible for covered care received outside the United States is a potentially useful improvement.

Bottom line

Anthem participants pay 16% more and receive fewer physical-therapy visits, but gain relief from the annual out-of-network deductible for covered care outside the United States.

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4. HIP Health Plan of New York

What changed?

Change	Effect on participant
Premium +7.16%	🔴 Pay more
No specific new benefit reductions identified in ST/IC/2026/2	— The circular does not identify major new coverage reductions for HIP

The 7.16% premium increase is the principal change identified for HIP in the circular.

Bottom line

HIP participants pay 7.16% more, with no specific new benefit reductions identified in the circular.

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5. Cigna US Dental PPO

What changed?

Change	Effect on participant
Premium +5%	🔴 Pay more
No specific new benefit reductions identified in ST/IC/2026/2	— The circular does not identify major new coverage reductions for the dental plan

The 5% premium increase is the principal change identified for the dental plan.

Bottom line

Cigna Dental participants pay 5% more, with no specific new benefit reductions identified in the circular.

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6. Medical Insurance Plan (MIP)

ST/IC/2026/3 covers the separate Medical Insurance Plan (MIP) for locally recruited staff at designated duty stations away from Headquarters. The MIP has three regional versions, administered by Cigna:

• Africa
• Asia-Pacific
• Europe and the Americas

What changed?

Change	Effect on participant
Higher premiums/contributions	🔴 Pay more. The circular says the new rates are 40% higher than those in ST/IC/2015/8. This is a comparison with the 2015 schedule, not a 40% increase in 2026 alone.
Outpatient emergency-room reimbursement: 100% → 80%	🔴 Pay more when using an outpatient ER
Annual-limit benefits excluded from stop-loss/hardship protection	🔴 Less protection against very high medical expenses
Nursing care: up to 8 hours/day for first 30 days	🟢 Clearer coverage
Nursing care after 30 days: up to 4 hours/day	🟡 More limited thereafter

Bottom line

The most significant MIP changes are higher premiums, a new 20% cost share for outpatient emergency-room care, and weaker protection against catastrophic expenses for benefits subject to annual limits.

The principal positive change is the clarification of nursing-care coverage.

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What explains the premium increases?

The 21 May 2026 AFICS/HLIS webinar provides important context.

HLIS explained that these are self-funded plans. Premiums are based on the projected cost of the plans, including claims costs and administrative fees. The presentation also explained that the financial risk when claims exceed premium collections is borne directly by the Organization.

HLIS presented loss ratios for Aetna, Anthem, Cigna Dental and the Worldwide Plan for the 2022–23 through 2025–26 insurance years. The presentation defines the loss ratio as programme costs divided by premiums collected and notes that when the loss ratio exceeds 100%, premium increases are required. 

The 2025–26 figures were projected using nine months of paid claims.

This is useful information. It shows that the premium increases are not arbitrary and that claims costs are an important driver.

But it does not answer every question.

The presentation does not quantify how much of each premium increase is attributable to the different factors. Nor does it provide a detailed breakdown of administrative costs or show how much particular cost-containment measures are saving.

That distinction matters.

Saying that premiums are based on claims costs plus administrative fees explains the basic mechanism. 

It does not tell participants exactly why a particular premium increased by 15%, 16%, 35% or 7.16%, or what portion of those increases reflects claims experience, utilization, medical inflation or administrative costs.

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What is being done to control costs?

The 21 May presentation also says that self-funding provides the UN with greater oversight and strategic control over plan design, financing and long-term sustainability.

That is significant.

It means that HLIS and the Organization are not simply passive purchasers of commercial insurance. 

They have considerable responsibility for managing the plans and controlling costs.

The presentation therefore provides some reassurance that cost control is part of the UN's role. But it does not give participants a detailed picture of what HLIS is actually doing to reduce costs, how much those measures are saving, or how the savings compare with the increases in medical costs.

This is an important unanswered question.

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Conclusion

The 2026 changes are not identical across the UN's health plans, but there is a clear overall pattern.

All five Headquarters-administered plans have higher premiums:

Plan	2026 premium increase
Aetna PPO/POS	35%
Anthem PPO	16%
UN Worldwide Plan	15%
HIP	7.16%
Cigna US Dental PPO	5%

At the same time, Anthem and the Worldwide Plan have specific benefit changes that reduce coverage in some areas, although Anthem also gains a potentially useful waiver of the out-of-network deductible for covered care outside the United States.

The MIP has its own separate set of changes, including higher premiums, increased cost-sharing for outpatient emergency-room care and weaker stop-loss/hardship protection for certain expenses.

The 21 May HLIS presentation provides some important context. It explains that the plans are self-funded, that premiums are based on projected claims costs and administrative fees, and that the UN bears the financial risk when claims exceed premium collections. The loss-ratio data also show the financial pressure facing several of the plans.

But important questions remain. Participants and retirees deserve greater transparency about:

• how much of each premium increase reflects claims experience, utilization, medical inflation and administrative costs;
• why particular benefits were reduced or restricted, and what savings those changes are expected to produce;
• what alternatives were considered before increasing participant costs or reducing benefits; and
• what HLIS is doing to control costs, and what measurable savings those efforts have achieved.

So the issue is not whether HLIS has explained why premiums are rising. It has provided a general explanation. 

The question is whether participants have enough information to understand how the increases were calculated, why these particular changes were chosen, and whether all reasonable cost-containment measures have been pursued before shifting more costs and financial risk onto participants.

For retirees and other participants, that is ultimately a question of affordability, benefit adequacy and accountability.

A final question: what is being done to ensure that UN retirees receive information about changes in insurance plans, in a timely manner, to make informed decisions.