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chapter I Coverage
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  • Article 1.1 Protected persons 
  • Article 1.2 Compulsorily insured persons 
  • Article 1.3 Voluntarily insured persons 
  • Article 1.4 Withdrawal of voluntarily insured persons 
  • Article 1.5 Automatically covered dependants 
  • Article 1.6 Voluntarily covered dependants 
  • Article 1.7 Coverage in exceptional cases 
  • Article 1.8 Coverage of officials of the International Centre for  Advanced Technical and Vocational Training, Turin

  • Article 1.1 Protected persons 

    1. The persons protected by the Fund shall comprise 

    (a) insured persons, being persons insured in their own right, either compulsorily or voluntarily, as staff members, former staff members, or survivors of such persons; 

    (b) specified categories of members of insured personsí families (hereinafter referred to as "dependants"), covered either automatically or voluntarily. 

    2. Insured persons are liable to pay contributions, as prescribed, both in respect of their own insurance and in respect of their dependants, and shall normally receive the benefits due in respect either of themselves or of their dependants
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    Article 1.2 Compulsorily insured persons

    1. The following shall be compulsorily insured persons:

    (a) Professional and General Service officials, other than part-time cleaning staff, who serve at the headquarters of the ILO or the ITU and have an appointment for a term of at least six months or, by virtue of an extension of appointment, are expected to serve continuously for at least six months; in the latter case, coverage shall be effective as from the first day of the month following the official notification of such extension;

    (b) Professional and non-local General Service officials serving at external offices of the ILO or ITU, subject to the conditions laid down in (a) above: Provided that such officials in any ILO liaison branch or national correspondentís office may choose to affiliate to a health insurance scheme available at their duty station and either sponsored by the United Nations or a specialized agency, or approved by the executive head of the organization employing them;

    (c) local General Service officials serving at external offices of the ILO or ITU, subject to the conditions laid down in (a) above, in so far as they are not eligible for affiliation to a scheme available at their duty station and approved by the executive head of the organization employing them;

    (d) except in so far as they are compulsorily insured under a health scheme in the country of the duty station, officials appointed to field projects subject to the conditions laid down in (a) above:
    Provided that the above paragraphs shall not apply to a part-time official:

    (i) who, being an automatically covered dependant under article 1.5 or insured under another health insurance scheme, opts not to become an insured person under the present article; or

    (ii) whose working week is less than half the normal working week of full-time officials at the same duty station.

    2. An official compulsorily insured in virtue of paragraph 1 of this article who is loaned to another international organization and to whom, during the loan, the Staff Regulations of the ILO or ITU continue to apply, shall remain compulsorily insured: Provided that such official, if loaned for at least one year, may choose to affiliate for the period of the loan to a scheme sponsored by the receiving organization.

    3. In this article, and in article 1.3, the words "the organization employing them" mean the ILO or ITU
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    Article 1.3 Voluntarily insured persons

    The following shall be entitled to be voluntarily insured persons:

    (a) officials on leave without salary or with partial salary who were insured persons at the date of taking the leave;

    (b) officials on secondment to other international organizations to whom the Staff Regulations of the ILO or ITU do not continue to apply and who were insured persons at the effective date of secondment, if application for voluntary insurance was made before such date;

    (c) officials whose service has ceased, provided they were insured persons immediately prior to the date of such cessation and application for voluntary insurance was made before that date. Voluntary insurance under this paragraph shall be for a maximum of six months after cessation of service;

    (d) former officials who have reached the age of 55 upon cessation of service, have had at least ten yearsí service with the United Nations or a specialized agency and have been, during the five years immediately preceding cessation of service, either insured persons of the Fund or otherwise protected against health risks by the organization employing them, if application for voluntary insurance was made and authorization to deduct the contributions from the pension signed before the effective date of cessation of service;

    (e) former officials receiving a disability pension from the UNJSPF or other ILO or ITU pension scheme, who, at the effective date of cessation of service, were insured persons of the Fund or of another health insurance scheme approved by the executive head of the organization employing them, if application for voluntary insurance was made and authorization to deduct the contributions from the pension signed within three months following the award of the disability pension;

    (f) widows or widowers of officials or former officials who at the time of death were insured persons of the Fund or of another health insurance scheme approved by the executive head of the organization employing them, if such survivors were automatically covered dependants at the time of the death and receive a survivorís benefit from the UNJSPF or other ILO or ITU pension scheme and if application for voluntary insurance was made and authorization to deduct the contributions from the pension signed within three months following notification by the Fund to the survivor of the provisions of this clause; if the official or former official died without leaving a widow or widower or upon the death of a widow or widower insured under this paragraph, these provisions shall apply in respect of any child who was at that time an automatically covered dependant and receives survivorís benefits from the UNJSPF or other ILO or ITU pension scheme.
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    Article 1.4 Withdrawal of voluntarily insured persons

    1. Voluntarily insured persons covered under article 1.3(d), (e) and (f) may withdraw from the Fund at three monthsí notice but, having done so, may not thereafter resume membership

    2. If such a voluntarily insured person becomes subject to compulsory health insurance coverage under a scheme of the United Nations or a specialized agency, voluntary insurance by the Fund shall be suspended as long as compulsory coverage continues.
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    Article 1.5 Automatically covered dependants

    1. The spouse and children of a person insured under article 1.2 or article 1.3(a), (b) or (c) shall be covered automatically in the following cases:

    (a) if family allowance is paid in respect of them under the Staff Regulations of the ILO or ITU or would be paid if the conditions of employment applicable to the insured person included provisions for family allowances corresponding to those contained in the respective Staff Regulations applicable to headquartersí staff;

    (b) if, under the respective Staff Regulations, staff assessment is applied to the salary of the insured person at the family rate by reason of the spouse or child in question;

    (c) in the case of a child who is not automatically covered by another health insurance scheme or medical care service, if a family allowance would be payable under the applicable Staff Regulations but is not paid only because of the receipt by the insured person or the insured personís spouse of an allowance of an equal or greater amount.

    2. The spouse and children of a person insured under article 1.3(d) or (e) shall be covered automatically if and for so long as they would have qualified for automatic coverage under paragraph 1 of this article had the insured person continued to be an official of the organization concerned; provided that a spouse who, by reason of the level of his/her occupational earnings, was not automatically covered at the date of cessation of service of the insured person, or at any time thereafter ceases to be automatically covered, may subsequently qualify for automatic coverage only if the spouse has no entitlement to continued protection by any insurance scheme in respect of health protection or medical care service which was applicable to the spouse by reason of the occupational activity in question.

    3. Children of widows or widowers insured under article 1.3(f) who were automatically covered under paragraph 1 of this article at the date of death of the insured person concerned shall, unless they are themselves qualified to be insured persons under article 1.3(f), continue to be automatically covered for so long as they would have qualified for such coverage under paragraph 1 of this article had the insured person continued to be an official of the organization concerned. For the purpose of this paragraph, a child born less than 300 days after the death of the official or former official concerned shall be assimilated to children automatically covered at the date of death.

    4. This article shall be applied to persons insured under article 1.3(a), (b) and (c) as if the remuneration on which their contributions are assessed were received from the ILO or ITU, as the case may be.
    Transitional provision. A parent who was automatically covered on 1 November 1983 under the provisions of article 1.5 in force prior to that date shall continue to be so covered so long as he/she satisfies the conditions laid down in those provisions. Such coverage shall cease if the insured personís spouse is covered automatically.
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    Article 1.6 Voluntarily covered dependants

    1. Subject to paragraph 2, the following dependants may, if they do not qualify for automatic coverage in accordance with article 1.5, be voluntarily covered as protected persons for renewable periods of one year:

    (a) the insured personís spouse;

    (b) the insured personís children who are under 30 years of age, unmarried and not in regular full-time employment;

    (c) the insured personís parents and parents-in-law, upon adequate evidence of continuous support in accordance with the criteria applied under the provisions of the respective Staff Regulations relating to family allowances for secondary dependants.

    2. The right to protection of any person under paragraph 1 shall arise only on the expiration of three months from the date on which the insured person has communicated to the Secretary of the Fund in writing notice of his/her intention to apply for protection of the person concerned. This notice requirement shall not apply to any application for protection made within two months of the insured personís entry into the Fund, nor where, within two months from the date on which a person ceases to be an automatically covered dependant under article 1.5, application is made for the continuance of protection of that person.

    3. If coverage is interrupted, it may be resumed only if the Management Committee considers that bona fide and adequate reasons existed for the interruption.

    4. In the event of the death of an insured person, the spouse, children, parents or parents-in-law who at the date of death were voluntarily protected under this article may become voluntarily insured as from that date, subject to the following conditions:

    (a) at the said date of death they must have been protected persons for not less than one year;

    (b) a child may become insured only if there is no surviving spouse and may remain insured only so long as satisfying the conditions stated in paragraph 1(b) of this article;

    (c) application for such insurance must be made within three months of the date of death;

    (d) article 1.5 and paragraph 1 of this article shall not apply to such insured persons;

    (e) they shall pay contributions at the rate established pursuant to article 3.5 for voluntarily protected dependants;
    (f) in all other respects they shall have the rights and obligations of persons insured under article 1.3.

    5. In the event of divorce, a spouse who at the date of the divorce was automatically protected under article 1.5 or voluntarily protected under this article may continue to be protected as from that date, provided that he or she had been a protected person for not less than one year and applies for such insurance within three months of the divorce. Such insurance shall be subject to the conditions specified in para. 4 (d), (e) and (f) of this article.
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    Article 1.7 Coverage in exceptional cases

    In exceptional cases the Management Committee may, by unanimous decision, admit as a protected person an official, former official or dependant not otherwise eligible for coverage under these Regulations. In such cases the Management Committee shall prescribe the conditions for coverage.
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    Article 1.8 Coverage of officials of theInternational Centre for Advanced Technical and Vocational Training, Turin

    1. Officials of the International Centre for Advanced Technical and Vocational Training, Turin, shall be compulsorily insured persons if they have an appointment of the duration indicated in article 1.2, paragraph 1(a).

    2. For the purposes of the application of article 2.9 (Employment injury), article 3.1 (Sources of financing) and article 3.7 (Deduction and transfer of contributions) of these Regulations, the said Centre shall have the obligations of a distinct employing organization.

    3. Subject to the preceding paragraph, the persons insured by virtue of this article shall, for the purposes of the application of these Regulations, be treated as if they were insured persons of the ILO.
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    Staff Health Insurance Fund
    Updated by SN. Approuved By YD. Last  modification: August 31,2001.