Modifications to the Rules of the CERN Health Insurance Scheme

On the proposal of the CHIS Board, and following examination by the Standing Concertation Committee on 29 April 2010, the Director-General has approved the new Rules of the CERN Health Insurance Scheme, which will come into effect on 1 June 2010.

The Rules will shortly be available on the CHIS web site.

As the Rules had not been revised since 2003, it had become necessary to make certain changes in order to bring them into line with other texts (such as the Staff Rules and Regulations and Administrative Circulars) and to clarify some practices.

The new Rules do not introduce any new benefits or remove any existing ones.

The following changes will affect all insured members:

  Description of change Articles in the
new Rules
Time limit for claiming reimbursement
  • The time period is measured from the invoice date (instead of the date of treatment).
  • Reduction of the time limit for submitting a claim from two years to twelve months.
  • Transitional arrangements until 31 May 2011 by which bills issued before 1 June 2010 may be submitted until 31 May 2011, provided that they do not date back more than two years at the time they are submitted.
 VIII 1.01
XI 1.01
Territorial scope (normal and reduced insurance)
  • Cover is world-wide, instead of being limited to Europe.
 III 3.01
IV 3.01
Extended cover
  • This category of cover has been discontinued in view of the redefinition of the territorial scope (see above).
 None


Other modifications will affect only some insured members:

  Description of change Articles in the new Rules
Voluntary membership (normal and reduced insurance)
  • The time limit for applying to join is now 30 days from the beginning of contract date (formerly 60 days).
  • Automatic extension if the contract with CERN is extended.
  • Possibility of obtaining or terminating membership within 30 days following changes in certain situations: e.g. change in the percentage of time worked at CERN, change to the mandatory cover provided by the employer, marriage or divorce.
 VII 5.02
VII 5.03
VII 5.04
Illness and accident
  • The texts have been brought into line with Administrative Circular 14 (Rev. 2), entitled "Protection of members of the personnel against the financial consequences of illness, accident and disability".
  • The articles on excluded risks and special risks have been deleted.
 II 1.02
II 1.03
Chapter VI
Indemnity in case of death
  • Benefit limited to staff members and members of their families.
 III 4.07
 
Excessive rates
  • New article to protect the Scheme against adverse effects of the free choice of provider by creating the possibility of limiting reimbursement in the event of excessive rates being charged.
 VII 4.07
Reserve Fund
  • Creation of a Reserve Fund at the end of 2008, separate from the CERN accounts.
 IX 2.01

Finally, the wording of some of the articles has been modified to make them more understandable.

If you have any questions, you should write to chis.info@cern.ch.

Tel. 74125 or 73853

by HR Department