Questions and Answers_Brussels.pdf

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Health Insurance for Locally Employed Staff (LES) U. S. Embassy Brussels, Belgium
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19GE5025R0064
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This document is a Questions and Answers (Q&A) file related to health insurance policies for the U.S. Embassy in Brussels, Belgium. The Q&A addresses specifics about two insurance policies (4.499.541 and 4.499.542) covering hospitalization and ambulatory care for locally employed staff. Key details include: both policies cover the same member population, are mandatory for active employees and voluntary for dependents, have a common premium split 90% by the employer and 10% by the employee, and are subject to the EPA clause in section B.3. The government indicates that average insured member counts for corresponding years are not available, and references additional statistical information contained on subsequent pages of the document.

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Ques�ons Health Insurance Brussels

Ques�on #001: In the document �tled “Atachment+4+Claims+History”, Please clarify the differences between policies 4.499.541 and 4.499.542 from the percep�ve of:

a. Member popula�on (ac�ve employees and dependents, re�rees and dependent)

b. Eligibility (voluntary or mandatory)

c. Premium rates (both groups have a common premium or separate premiums based on each group’s risk profile)

d. Who pays premium for each of the groups

e. Does EPA clause sec�on B.3 apply to both groups

f. Average insured member counts for the years men�oned in the table 4.499.541 and 4.499.542

(Please add a column to each of two tables indica�ng average member counts for corresponding years)

Answer #001: GENERAL REMARK; policy 4.499.541 is the hospitaliza�on insurance and policy

4.499.542 is the ambulatory care policy.

a. There is no difference between the members as the member popula�on for both policies are the same.

b. Difference for both policies: mandatory for ac�ve employees, voluntary for dependents.

c. Both groups have a common premium.

d. Difference for both policies: 90% employer and 10% employee.

e. Yes, the EPA clause in sec�on B.3 does apply for both groups

f. Please see the second page of the combined sta�s�cs of hospitaliza�on insurance and ambulatory care, the third page the sta�s�cs of hospitaliza�on insurance and the fourth page the sta�s�cs of ambulatory care. The government does not have the average insured member counts for the insurance for corresponding years.

File details come from the government source that posted it. Updated .