FAQ

AFILIATYS has not negotiated higher premiums with ALLIANZ CARE.  As explained in the message of 10 April 2019, AFILIATYS was legally required to launch a call for tenders, given that the contract with CIGNA comes to an end on 31/12/2019 (something which had not been done for over 40 years).  The best offer was chosen (particularly regarding the financial terms offered).  Please remember that the current level of premiums date back 10 years and would have needed to be updated in any case.

See also question 9.

Yes.

It would be up to you to inform ALLIANZ CARE and then negotiate your new premiums with CIGNA for a different policy from HOSPI SAFE, even if it was similar.

Please remember that in the new contract with ALLIANZ CARE, premiums will be fixed as from 61 years of age, as opposed to the present situation where they are reassessed at age 68.

All new claims for reimbursement should be sent to ALLIANZ CARE BRUXELLES and the premiums paid to ALLIANZ CARE who will inform all members about what needs to be done.

Yes.  HOSPI SAFE remains HOSPI SAFE. The new contract contains all the existing rules of the present contract.

The only thing that changes will be the broker.  The procedures for requesting reimbursement will be same as current procedures.  In the case of hospitalisation within the European Economic Area, ALLIANZ CARE will reimburse 100% of your medical expenses WITH NO CEILING.

As from 01/01/2020, enrolment can be done at any time prior to retirement.

However, it is advisable to join as soon as possible given that if enrolment is requested less than 6 months prior to retirement, then a medical questionnaire has to be completed.

It’s very simple:

1. Complete the online application form (the website address will be supplied in due course)
2. Or complete and sign the document and return it by email or by post to ALLIANZ CARE

HOSPI SAFE is a group contract negotiated by AFILIATYS.  It is therefore essential to first join the association in order to be able to take advantage of its benefits.  Membership costs just €5 and lasts a lifetime!

To join, please go to the following site: https://www.AFILIATYS.eu/en/subscribe.cfm

No.  Each family member can choose the options they prefer.

NB: This level of premium is fixed as from age 61 (cf. questions 2 and 16).  However, those aged 61-67 will pay a higher premium in 2020 than in 2019: €1,784.13 instead of €1,450.

COMMENTS:

1. 1. The premium for the 61-67 age group, fixed for the past 10 years apart from indexation, would have been duly raised on 01/01/2020 from €1,450 to €1,609.15
   2. If the 68+ age group had been maintained, the premium would have been raised to €2,128.82.

Yes.  Coverage will be transferred automatically on 1/1/2020.  You don’t have to do anything.

You can join now if you wish (cf. questions 6, 7 and 13).   The conditions will remain unchanged, apart from the premiums and address.

Before 1/1/2020: CIGNA (NB. These premiums will only be valid until 31/12/2019).

 HOSPI SAFE (Hospitalisation sickness/accident)

HOSPI SAFE PLUS (Hospitalisation and out-patient treatments)

After 1/1/2020: ALLIANZ CARE

HOSPI SAFE (Hospitalisation sickness/accident)

HOSPI SAFE MALADIE (Hospitalisation sickness only)

HOSPI SAFE PLUS (Hospitalisation and out-patient treatments)

Yes.  However, there will be a maximum global reimbursement of 25 000€ per calendar year per person insured for the reimbursement of expenses incurred outside the European Economic Area (EEA).

NB: Please note that medical evacuation is never reimbursed (nor by the JSIS).  This needs to be covered by a separate travel insurance policy, which is strongly recommended by the JSIS.

Yes, that’s correct, as long as the application to join is made at least 6 months prior to retirement.  If not, then it will still be necessary to complete a questionnaire.

Please note the following exclusion clause

Exclusion:  the healthcare costs for hospitalisation related to an infirmity and/or illness that existed at the time of affiliation of the insured and that had already manifested itself through objective symptoms that could be diagnosed. However, the cover is acquired if, during the TWO YEARS following affiliation, the insured was not hospitalised for, or did not have any medical treatment related to the pre-existing cause.

You must be in active service in one of the European Institutions or Agencies (and a member of AFILIATYS), covered by the JSIS or have been covered by it.

Members of AFILIATYS can therefore join as the main member of HOSPI SAFE, as long as they are covered by the JSIS or benefit from an equivalent cover.

Other family members who can be covered through the main member:

• • The spouse/recognised partner of the main member
  • Their dependent children or other recognised dependent person (including adopted children), up to age 26
  • The beneficiaries of a survivor’s pension (widow/er, orphans) as long as the deceased person was a main member of HOSPI SAFE, on condition they can provide proof of partial reimbursement by the JSIS or by their own national health scheme

This insurance is valid for life.

1. It is not possible to join once you have retired

09It only covers hospital stays costs linked to sickness, not those linked to accidents.  The latter are covered by Art.73 for active staff (or by the specific accident policy negotiated by AIACE-CIGNA for pensioners, or any other accident specific policy).

Yes. Changes can be requested at any time to reduce or increase the level of coverage.

However, any such request but will only take effect on the date the next premium is due

ALLIANZ CARE will set out the conditions for changing from HOSPI SAFE to HOSPI SAFE PLUS.

HOSPI SAFE remains valid for life.  Nothing needs to be done on retirement.

NEW: As from 01/01/2019, premiums will remain unchanged as from age 61 (instead of age 67 under the current contract) and are guaranteed for a 10-year period each time, apart from annual Eurostat indexation and a possible (negotiated) revision after 5 years.

1. NB. The passage from one age group to the next (implying an increase in premium) will only take effect from the date the next premium is due.
2. NB.  On retirement make sure you inform ALLIANZ CARE and AFILIATYS of your new email address and postal address.

Yes, they are reimbursed as for sickness costs, ie: reimbursement is limited to a maximum of 80-85%.

VERY IMPORTANT: On retirement, Art. 73 of the Staff Regulations no longer applies:

• • There is no complementary reimbursement up the 100%
  • There is no longer a lump sum payment in case of death
  • There is no longer a lump sum payment in case of permanent disability

See also question 30.

Non.

Yes.  You just need to send ALLIANZ CARE the original form for a SEPA deduction to be made from your account.

1. A copy will not be accepted.   The standing order request will only apply to future payments

Yes.  The totality of the premium initially requested must be paid.  The amount overpaid will be subsequently reimbursed to you (on provision of your bank account details).

It will be the same as now, on the basis of the JSIS account sheet, and can be done in one of the following 4 ways:

• • by posting the form to ALLIANZ CARE, 1 Place du Samedi, 1000 Brussels
  • by downloading the reimbursement form
  • online via the web page
  • on your smart phone using the app MyHealthApp

After activating it, you’ll be able to check your claims for reimbursement via the website on your personal pages.

There is no restriction regarding the choice of hospital, private or otherwise.

Freedom of choice of doctor and hospital is guarante

There is no restriction regarding the choice of hospital, private or otherwise.

Freedom of choice of doctor and hospital is guaranteed by the Staff Regulations and is also respected by the insurance policy.

ed by the Staff Regulations and is also respected by the insurance policy.

The appropriate formalities will be the subject of a specific notification in November. Any enrolment before that date should be made with CIGNA by completing a medical questionnaire (up to and including 31/12/2019).

Yes. As from 01/01/2020 it will be possible to enrol in HOSPI SAFE up to the last day before retirement. However, you will have to complete a medical questionnaire for any request to join during the last 6 months prior to retirement.

This case highlights a serious misunderstanding which AFILIATYS wishes to draw to your attention.

VERY IMPORTANT: the change of broker ONLY concerns the HOSPI SAFE policies negotiated by AFILIATYS.

The CIGNA/AIACE accident policy has nothing to do with AFILIATYS and is NOT concerned by this change of broker. Any questions regarding this policy should be addressed directly to AIACE.

It is no longer possible to do so.  This policy must be taken out PRIOR to retirement (on the date itself on 01/01/2020).

As explained in points 13 and 33, HOSPI SAFE SICKNESS/ACCIDENT must be taken out before retirement begins (as from 01/01/2020 it can still be taken out on the very day of retirement).

For your information, AIACE has negotiated a complementary insurance policy especially aimed at pensioners, ie: “Major Risks and Accidents”.

The HOSPI SAFE SICKNESS/ACCIDENTS covers the medical costs resulting from an accident requiring a stay in hospital.

Yes.  If you enrol before the end of December 2019, CIGNA will only charge you a pro rata premium for the period until 31/12/2019.  Given that the policy will be automatically transferred to ALLIANZ CARE on 01/01/2020, they will bill you for the new premium to cover the new period.

UFPE ceased to exist more than 10 years ago.  AFILIATYS took over from UFPE.  Members were automatically transferred to AFILIATYS, unless waived by them.

If this didn’t happen, please contact AFILIATYS (duty office on Tuesdays and Thursdays from 10am to 3pm – or via their website www.AFILIATYS.eu).

Pregnant ladies are invited to join HOSPI SAFE as a complement to the JSIS. In case of hospitalisation, the new born baby will be covered free of charge for the first 2 years.  Up to the end of 2019 a medical questionnaire must be completed. It is also necessary to join AFILIATYS (€5 as a lifetime subscription).

Yes, but up to 31/12/2019 a medical questionnaire will be required.

This will not be the case on 01/0/2020 (except if subscription takes place at least 6 months prior to retirement), but a waiting period of 2 years is foreseen:

Exclusion:  the healthcare costs for hospitalisation related to an infirmity and/or illness that existed at the time of affiliation of the insured and that had already manifested itself through objective symptoms that could be diagnosed. However, the cover is acquired if, during the TWO YEARS following affiliation, the insured was not hospitalised for, or did not have any medical treatment related to the pre-existing cause.

The policies suggested are valid in all countries of the European Economic Area.

As foreseen by our Staff Regulations, there is no restriction for any country within the EU.

No, but he can request a 12-month extension from the JSIS given that he will still be a student.

Like the JSIS, only children recognised as disabled, can remain covered beyond 26 years of age.

After 26 (apart from the said 12 months), to replace the JSIS and any complementary health scheme, the child should join a national health scheme in their country of residence, such as a mutuelle or a complete policy with DKV or Partana, etc).

AFILIATYS is absolutely not concerned with this policy which was negotiated by AIACE. It will always remain in the hands of CIGNA.  Any questions regarding it should be addressed to AIACE who are responsible for this policy.

No.  But she could be covered by SANTALIA whose age limit is 75.

Follow the procedures already established by JSIS and AFILIATYS, ie:

• • request a letter of direct billing
  • Do not pay any bills yourself, of any kind
  • Await the JSIS account sheet
  • Send the account sheet to HOSPI SAFE to claim reimbursement – to CIGNA until 31/12/2019 – to ALLIANZ CARE as from 01/01/2020.

The spouse can remain covered by HOSPI SAFE, and can even start being covered if he/she is not yet 65 years old.  At the moment, if it’s a new membership, a medical questionnaire would need to be completed.

As from 01/01/2020, it would depend on the age of the spouse, on their situation as a pensioner or someone still working.  The premium would be calculated according to their age, regardless of whether or not they are covered by the JSIS.

1. For beneficiaries no longer covered by the JSIS, the level of reimbursement from HOSPI SAFE will be the same as though the person had been reimbursed by the JSIS.

No – given that you have a disability pension and not a disability allowance.

The alternative would be to take out the Major Risks and Accident policy negotiated by AIACE.

Indeed, AFILIATYS is aware of this redundancy for active staff members which guarantees reimbursement at 100% for medical expenses linked to an accident.  It is for this reason that it negotiated a third option with ALLIANZ CARE which will be available from 01/01/2020:  HOSPI SAFE SICKNESS (with the possibility for both active staff and pensioners to switch to HOSPI SAFE SICKNESS/ACCIDENT with no formalities).

In this way, once retired, the member who benefits from HOSPI SAFE SICKNESS will be able to ask for a switch to HOSPI SAFE SICKNESS/ACCIDENT, WITHOUT HAVING TO COMPLETE A MEDICAL QUESTIONNAIRE, (if he/she has no other specific accident insurance). The opposite would also be possible.

The premium would be adjusted accordingly.

HOSPI SAFE (Hospitalisations maladie/accident)

HOSPI SAFE MALADIE (Hospitalisations maladie seulement)

IMPORTANT: Yes, indeed, Article 73 no longer applies to pensioners.  But Article 72 continues to cover them for all medical costs linked to an accident (up to 80-85%).

HOSPI SAFE SICKNESS/ACCIDENT will continue to reimburse you at 100% for costs linked to any hospitalisation linked to an accident.

On the other hand, if you wish to continue to benefit from a lump sum in case of death resulting from an accident, or in case of any permanent disability, then yes, you should subscribe to the AIACE accident policy.

AFILIATYS recommande de l’informer du changement de l’adresse e-mail (www.Afiliatys.be). A défaut ses membres ne peuvent plus recevoir ses informations.[:en]The premium is the same, regardless of where you live when you retire.

AFILIATYS recommends that you inform it of your change of address and e-mail address when you retire (www.AFILIATYS.eu).  If you don’t do this, then you will no longer receive any information from AFILIATYS.

CIGNA is not changing name but the broker of HOSPI SAFE will change on 01/01/2020 from CIGNA to ALLIANZ CARE. AFILIATYS has already informed its members several times about this change.

HOSPI SAFE SICKNESS/ACCIDENT covers all costs linked to a stay in hospital (2 months before the operation and for 6 months after the operation).

HOSPI SAFE PLUS whose premiums are indeed higher reimburses all medical acts, within the limits however of certain ceilings (cf. https://www.eurprivileges.com/sites/default.files/eurpri/media.AFILIATYS)

1. As it is a health insurance policy complementary to the JSIS, HOSPI SAFE PLUS only reimburses if the JSIS reimburses the item in question (with the exception of certain expenses – see the table below). Sessions with a physiotherapist are reimbursable.

HOSPI SAFE

• • Hospitalisation
  • Surgical operation
  • Out-patient costs
  • Pregnancy
    • Reimbursement at 100% of the expenses not reimbursed by the JSIS
    • NO CEILINGS

HOSPI SAFE PLUS (All the above items covered by HOSPI SAFE and more)

• • Dental costs (max €3,200 per year after year 4)
  • Optical costs (with ceiling)
  • Various therapies taken as sessions
  • Hearing aids (with ceiling)
  • Orthopaedic equipment
  • Medical consultations
  • Pharmaceutical products
  • Medical imagery
  • Speech therapy for non-medical reasons
    • Reimbursement at 80% of the expenses not reimbursed by the JSIS
    • Ceilings and deductibles might apply

• • Enrolment in a sports club or in a slimming programme
    • Reimbursement at 20%
    • Ceilings and deductibles might apply

The staff member or pensioner pays their own premiums.  The Institution does not pay them.

The premium is paid annually in January.

If you join in the middle of the year, you will only pay a pro-rata premium to cover the rest of the year.

The premium is payable quarterly (January, April, July, October).

If you join HOSPI SAFE PLUS after October, you will only pay a pro-rata premium up to the end of the year.

The new premium will be due in January of the following year.

The cover would be maximum if a Dependency chapter is added to the JSIS Sickness Insurance Rules (cf. pages 21 – 27).

However, the reimbursement will not be at 100% if it does not relate to a stay in hospital or to an accident.  In addition, the JSIS reimbursements for dependency take account of the level of salary/pension.

Unless you choose to cancel your HOSPI SAFE policy (negotiated by AFILIATYS), it will automatically continue on retirement.  It covers the same risks as the MAJOR RISKS/ACCIDENT policy negotiated by AIACE.

In so far as HOSPI SAFE is concerned, for the 61+ age group, the premiums as from 01/01/2020 will be:

€242.99 for HOSPI SAFE SICKNESS/ACCIDENT (no deductibles)

€178.41 for HOSPI SAFE SICKNESS

As far as the MAJOR RISKS/ACCIDENT, the premiums are as follows:

IMPORTANT: the HOSPI SAFE premiums remain the same (apart from contractual indexation foreseen under point 18).  Such is not the case for other policies covering the same risks as premiums can be revised in line with statistical data.[:]

The EFFECTIVE date of your retirement will be the official date when you cease working in the Institutions.  CIGNA asks “I confirm that I will be in active service for at least another 6 months”, you should answer affirmatively.

Up until 31/12/219 a medical questionnaire is still required by CIGNA.  This will no longer be the case as from 01/01/2020 for those joining within 6 months of retirement (but there will be a waiting period of 2 years as opposed to 1 year at the moment).