FAES Insurance Open Enrollment: September 10-24, 2025
FAES Insurance Open Enrollment: September 10-24
Medical/Prescription and Dental Plans for 2025-2026 Plan Year
Effective November 1, 2025
Since 1959 the Foundation for Advanced Education in the Sciences (FAES) has been working to support the professional and educational mission of the National Institutes of Health. This support includes a health insurance program for select members of the NIH community. Over the years FAES has made many changes to ensure a robust and sustainable insurance plan for members.
FAES will continue to offer the Luminare Health/Aetna Signature Administrators PPO Medical/Prescription plan and the MetLife Dental plan for the 2025-2026 plan year.
Changes for the 2025-2026 plan year are:
Medical
- Out-of-pocket maximum for in-network services is set to $2,000 for an individual and $4,000 for a family.
- Out-of-pocket maximum for out-of-network services is set to $4,500 for an individual and $9,000 for a family.
- In-network coinsurance is set to 10% when coinsurance is applicable.
- Coinsurance of 10% will apply to maternity delivery and facility services after the deductible is met.
- Added eye exam to medical plan covered at 100% for both in-network or out-of-network providers.
Pharmacy
- Added prescription deductible of $100 for an individual and $200 for a family that applies to Tier 1, 2, 3 and Specialty (not preferred preventive drugs).
- Expanded prescriptions that require prior authorization. If you are currently taking a medication that will require prior authorization, you will receive notice from RxBenefits with instructions for submitting prior authorization prior to 11/1/25.
Pregnancy and Postpartum
- Added Pregnancy and Postpartum program through Progyny available to Fellows and their covered dependents. Progyny provides one-on-one, personalized support and education.
Dental
- New MetLife group/policy number.
Vision
- Discontinue plan through MetLife.
- Added eye exam to medical plan covered at 100% for both in-network or out-of-network providers.
The 2025-2026 benefits guide and insurance plan video will be posted on the FAES Insurance website ahead of Open Enrollment.
Open Enrollment is a time when members can make changes to their insurance election. Changes can include switching from individual coverage to family coverage (or vice versa), dropping coverage all together, or enrolling if they previously waived coverage. If members wish to make changes, please contact the FAES Insurance department by email or phone. Changes will take effect with the start of our new plan year on November 1, 2025.
If members are currently enrolled and will not be making any changes for the new plan year, they will not need to fill out new paperwork.
FAES Insurance will host daily (Monday-Friday) Open Enrollment Information Sessions via Teams, September 10-24 at 3pm.
Microsoft Teams
Meeting ID: 255 606 800 235 4
Passcode: Da7c7Jy9
Please send all inquiries to faesinsurance@mail.nih.gov