4 September 2026 - Letter from FAFICS President - changes to UNHQ-administered health insurance plans

Dear colleagues and friends,

Since the changes to the UN Headquarters-administered health insurance plans took effect on 1 July 2026, many of your members have written to your Association and/or to me directly. Your concerns are legitimate, and I want to address them directly, and to tell you plainly what FAFICS is doing about them.

What changed. The changes are described in two UN Information Circulars — ST/IC/2026/2 and ST/IC/2026/3 — an increase in premiums across every UN Headquarters-administered plan, in some cases by as much as 40 per cent, and benefit changes such as higher out-of-pocket thresholds and reduced physical therapy coverage.

These increases follow years in which claims have exceeded contributions system-wide, driven mainly by an ageing population, costlier post-pandemic care, and shrinking plan reserves which were used in the past to absorb part of increases in some of the plans with sufficient reserves. Contribution levels for participants and the Organization were increased accordingly, in line with the cost-sharing ratios approved by the General Assembly.

Retiree representatives from AFICS/NY continued their efforts to advocate for the broadest possible benefits at the most reasonable cost possible during the Health and Life Insurance Committee (HLIC) review of the plans. I encourage every retiree to read the circular covering their own plan directly, rather than rely on second-hand accounts.

What FAFICS is doing. FAFICS advocates for equitable access to health insurance benefits at the most reasonable cost possible. Our mandate is to be the unified, system-wide voice of retirees — raising issues that no single Association may be able to address alone.

In recent months we have written formally to the most senior UN management responsible for health insurance policy, pressing for stronger funding arrangements, full voting representation of retirees on health insurance committees, better-value coverage, and to allow the President of FAFICS to address the High-Level Committee on Management (HLCM) on issues of concern to retirees.

We ran the largest survey of its kind in relation to claims’ processing/appeal mechanisms as well as long-term care awareness — over 2,400 responses from 48 Associations — to build a solid evidence base, and we have turned that evidence into seven concrete recommendations adopted at our 56th Council session in Vienna this July, now driving our 2026–2027 work plan. We also coordinate closely with FICSA, UNISERV and CCISCUA, so that the voice of retirees carries real weight. A detailed account of these actions is set out in the Annex to this message (which is included in the PDF of this letter).

What your members can do. If your members have concerns with the level of benefits or other general issues related to their health insurance policy, they should raise it with their former organization and if necessary, with their local AFICS. If a claim is rejected or an enquiry goes unanswered: the matter should be raised first with their plan’s claims administrator; if unresolved, it can be raised with the health insurance unit of their former organization; if the matter persists, it can be brought to the attention of their local AFICS, which can escalate generic, system-wide issues to FAFICS. 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. FAFICS will keep reporting to you, regularly and in plain terms, on what we are doing and achieving. This is our commitment to you.

Darshak Shah

President, FAFICS

This letter, including the annex, is also available for download in English, French and Spanish.

ANNEX

Detailed account of the 2026 plan changes and of FAFICS’s actions

This Annex complements the President’s message with the fuller, more technical record of the plan changes and of the steps FAFICS has taken. It is provided for Associations and retirees who wish to go beyond the summary.

I. The 2026 changes in detail for UN Headquarters-administered health insurance plans

The UN health insurance plans are self-insured, meaning that the UN and plan participants jointly bear the financial risk if claims exceed contributions. The UN Health and Life Insurance Committee (HLIC), composed of management and staff representatives, with AFICS/NY, UNDP and UNICEF participating as Observers, plays a key role in overseeing the plans. HLIC recommends to UN management changes to benefits, premium adjustments, and measures involving third-party administrators (TPAs), where applicable.

Retiree representatives from AFICS/NY are an important part of the HLIC process. Working with management and staff representatives, they review data from TPAs and UN Health and Life Insurance Section (HLIS) and make recommendations on a consensus basis. This includes claims experience and plan utilization, projected medical cost trends, proposed benefit changes, cost-avoidance initiatives, plan reserves, and loss ratios—the proportion of claims costs to contributions collected over a given period. Retiree representatives continued their efforts to advocate for the broadest possible benefits at the most reasonable cost possible during the discussions.

The 2026/27 premiums were established based on the previous year’s actual claims experience, projected claims costs, administrative expenses, and the level of plan reserves. In its May 2026 briefing to participants, the UN HLIS reported that loss ratios exceeded 100 percent under some of the plans. Continued deterioration in loss ratios for some of the plans had depleted reserves to the point that they could no longer cover the resulting shortfall. Contribution levels for both participants and the Organization were therefore increased in accordance with the cost-sharing ratios approved by the General Assembly.

¹ ST/IC/2026/3 concerns only the UN Secretariat’s Medical Insurance Plan (MIP). Other UN organizations administer their own MIP, and contribution rates and benefit levels may differ.

Sources: ST/IC/2026/2 (five UNHQ-administered plans); ST/IC/2026/3 (UN-MIP). Recordings, presentations and Q&A from the HLIS/AFICS/NY webinar and from the 2026 annual enrollment campaign are available on the HLIS website.

II. FAFICS’s actions in detail

1. Role and mandate

FAFICS advocates for equitable access to health insurance benefits at the most reasonable cost possible. Its role is to represent and protect the interests of UN retirees across the whole UN system, providing a system-wide voice that individual Associations may find harder to sustain alone — important because a change in one Organization can quickly become an issue for retirees elsewhere. Issues are escalated to FAFICS only after they have been raised and discussed by individual Associations and shown to have wider, system-wide implications. While FAFICS does not sit directly on any Organization’s health insurance committees, it encourages it’s member Associations to urge their representatives sitting on such committees to actively participate in the discussions on any changes to the plans and advocate for health insurance benefits at the most reasonable cost possible.

2. Advocacy with senior UN management

FAFICS has advocated in its meetings with UN senior management for improved funding arrangements for After-Service Health Insurance (ASHI), for full membership (rather than observer status) for retirees on Organizations’ Health Insurance Committees, because that is where retiree representatives, alongside other Committee members, analyze plan-usage data, review the benefits offered, and advocate for the broadest possible coverage at the most reasonable cost for all plans including enhancements to MIP. On 15 April 2026, the former President of FAFICS wrote to the UN Under-Secretary-General for Management Strategy, Policy and Compliance, in her capacity as Chair of the High-Level Committee on Management (HLCM), raising these issues — a follow-up to an earlier letter sent in January 2025 to the Secretary-General, in his capacity as Chair of the Chief Executives Board (CEB). FAFICS also requested that the President of FAFICS be able to address the High-Level Committee on Management (HLCM) on issues of concern to retirees.

3. Evidence-gathering: the 2026 ASHIL survey

The FAFICS Standing Committee on After-Service Health Insurance and Long-Term Care (ASHIL) conducted a global survey in 2026, in response to concerns raised by Associations about third-party administrators (TPAs) and the claims and appeals process. The survey drew 2,420 responses from 48 Associations — the strongest evidence base FAFICS has ever assembled on these issues. It found that only about a third of retirees understand the claims appeal process, and that awareness of long-term care issues and necessity for planning remains low, particularly in Africa and Asia.

Africa and Asia.

4. Council-adopted work plan

At its 56th Council session, held in Vienna in July 2026, FAFICS adopted seven recommendations on health insurance issues for 2026–2027. These include work on the medical evacuation gap affecting retirees in the regions concerned, on the transparency of the claims and appeals process, and on MIP-related issues, and long-term care (raising the level of awareness). Together, these recommendations now form ASHIL’s work plan for the current period.

5. Coordination with other staff and retiree bodies

FAFICS continues to work closely with FICSA — which has adopted a resolution supporting the participation of the FAFICS Standing Committee on ASHIL in its relevant quarterly Committee meetings — as well as with UNISERV and CCISCUA. The interests of retirees and of serving staff are closely aligned, which makes this collaboration essential.

III. If you have an issue with your coverage

·                Check the rules and the Information Circular issued by the Organization responsible for your plan.

·                Raise the issue first with the TPA or claims administrator handling your plan.

·                If unresolved, contact the health insurance unit of your former organization.

·                If it persists, bring it to your AFICS at the country level, which can escalate to the AFICS at headquarters level of your former organization.

Generic, system-wide issues can then be brought to FAFICS. FAFICS cannot resolve individual cases across its 65 Associations, but concrete cases directly inform and sharpen its advocacy.