Aetna Student Health SM Rochester Institute of Technology's choice for student health insurance

Transcription

1 Aetna Student Health SM Rochester Institute of Technology's choice for student health insurance (5/13) 9365

2 RIT RIT is is concerned about the the health, safety and general physical and mental well-being RIT is concerned of of our our about students. the We health, We recognize safety and that general students physical may encounter and mental well-being of our accidents students. and We and recognize sickness while that students enrolled at may at RIT. encounter Our Student accidents Health and Center sickness is is while enrolled available at RIT. Our for for Student students Health to to use use Center when is medical available attention for students is is needed. to use To when supplement medical attention this, this, RIT RIT offers a voluntary student insurance program that is is underwritten by by Aetna needed. Student To supplement Health and this, brokered RIT offers through a voluntary University student Health insurance Plans, program Inc. that is All All underwritten students are are by required Aetna Student to to have Health adequate and medical brokered insurance through University coverage. Health Plans, Inc. All students are required to have adequate medical insurance coverage. The Rochester Institute of Technology is underwritten by Aetna Life Insurance Company (Aetna) and administered by Chickering Claims Administrators, Inc. Aetna Student Health SM SM is the brand name for products and services provided by Aetna Life Insurance Company (Aetna) and CCA and their applicable affiliated companies (Aetna).

3 You have found the school that s the right fit Now choose the insurance plan that s the right fit Aetna Student Health custom protection for you Health insurance coverage any time school, travel, summer Large nationwide network of doctors, hospitals and specialists Savings on dental, vision and pharmacy services No-hassle payment. It can be included in your tuition bill But what if I already have insurance? Check us out. You may be able to do better on costs Your plan may not cover you this far from home don t take a chance Aetna Student Health More than 200 colleges and universities use our services. We ve been in the student insurance business for more than 30 years. What else is included? Access to travel assistance services, including 24/7 emergency assistance Access to discounts on massage therapy, over-the-counter vitamins, oral health care products, acupuncture, and weight-loss programs and products to name a few Quit smoking: One year of personal coaching, interactive web tools and motivational materials What I can buy from Aetna Student Health even if I decide not to buy this insurance: Discount programs on dental and prescription services To find out more about the plan and to sign up, go to

4 Here's what the plan offers Here is a brief description of the plan benefits. Aggregate Maximum: $500,000 per sickness per policy year Pharmacy Maximum: $500,000 per policy year Basic Accident Plan Maximum $500,000 per Accidental Injury Basic Sickness Preferred Non-Preferred Plan Expenses Physician's Office Visit Inpatient Hospitalization Emergency Room Outpatient Mental Prescription Drug Negotiated Charge for Recognized Charge for the first $2000 of the first $2000 of Medical Expenses: Medical Expenses: 80% thereafter 80% thereafter 80% of the Negotiated 80% of the Recognized Charge per sickness Charge for a semiprivate per policy year room Negotiated Charge for Recognized Charge for the first $2000 of the first $2000 of Medical Expenses: Medical Expenses: 80% thereafter 80% thereafter Negotiated Charge for Recognized Charge for the first $2000 of the first $2000 of Medical Expenses: Medical Expenses: 80% thereafter 80% thereafter Negotiated Charge after a $10 copay for generic drugs; $30 for brand name drugs Recognized Charge after a $10 copay for generic drugs; $30 for brand name drugs Basic Accident Plan Expenses Preferred Non-Preferred Accident Coverage 100% Negotiated Rate of the first $3,000 of Covered Medical Expenses; 80%Negotiated Rate thereafter 100% Recognized Charge of the first $3,000 of Covered Medical Expenses:80% Recognized Charge thereafter

5 Please read carefully before deciding whether this plan is right for you: This plan will not pay more than the overall maximum benefit of $500,000 per condition per policy year during the plan year. This plan will not pay more than $500,000 per condition per policy year during the plan year. Once any of these limits have been reached, the plan will not pay any more toward the cost of the applicable services, and your health care provider can bill you for what the plan does not pay. Some illnesses cost more to treat than this plan will cover. Please read the Rochester Institute of Technology brochure at carefully before enrolling. While this document and the Rochester Institute of Technology brochure describe important features of the plan, there may be other specifics of the plan that are important to you, and some limit what the plan will pay. If you want to look at the full plan description, which is contained in the Master Policy issued to the school, you may view it at or contact us at For more information on other plan exclusions, limitations and benefits maximums, please refer to the Rochester Institute of Technology's brochure and Master Policy. This plan pays benefits only for expenses incurred while the coverage is in force and only for the medically necessary treatment of injury or disease. The coverage displayed in this document reflects certain mandate(s) of the state in which the policy was written. However, certain federal laws and regulations could also affect how this coverage pays. Unless otherwise indicated, all benefits and limitations are per covered person. Where can I go for service? First stop, the student health center. When you need care, consider the student health center as your first stop. They can provide many of the routine health services you need. You also may visit any licensed health care provider directly for covered services in Aetna s preferred provider* network (doctors, specialists, facilities) except that specific plan restrictions on certain services may apply. However, when you visit the student health center first, you ll generally pay less out of your own pocket for your care. To learn more about preferred providers, visit *Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services.

6 insured benefits. The member is responsible for the full cost of the discounted services. Discounts and programs may be offered by vendors who are independent contractors The discount and offers not and employees programs or agents above provide of Aetna. access Aetna to may discounted receive a prices percentage and are of NOT the fee insured you pay benefits. to a discount The member vendor. is These responsible services, programs for the full or benefits cost of may the be discounted offered by vendors services. who Discounts are independent and programs contractors may and be not offered employees by vendors agents who of Chickering are independent Claims Administrators, contractors and Inc., not Aetna employees Life Insurance or agents Company of Aetna. or Aetna their may affiliates. receive a percentage of the Discount fee you pay programs to a discount and travel vendor. assistance These services, programs may be or offered benefits by may vendors be offered who are by independent vendors who are contractors independent and not contractors employees and or not agents employees of Aetna or or agents their of affiliates. Chickering Claims Health Administrators, information Inc., programs Aetna Life provide Insurance general Company health or information their affiliates. and are not a substitute for diagnosis Discount or programs treatment and by travel a physician assistance or other services health may care professional. be offered by vendors who are Providers independent are contractors independent and contractors not employees and are or agents not agents of Aetna of Aetna. or their Provider affiliates. participation may Health change information without programs notice. provide Aetna general does health not provide information care and or are guarantee not a substitute access for to health.services. diagnosis or treatment by a physician or other health care professional. Policy Providers forms are issued independent OK include: contractors GR and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health.services. Your student health insurance coverage, offered by Aetna Student Policy forms issued in OK include: GR Health, may not meet the minimum standards required by the Your health student care reform health law insurance for the coverage, restrictions offered on annual by Aetna dollar Student limits. Health, The annual may dollar not meet limits the ensure minimum that standards consumers required have sufficient by the health access to care medical reform benefits law for throughout the restrictions the annual the on annual term dollar of term the of policy. limits. the policy. The Restrictions annual Restrictions for dollar annual for limits annual dollar ensure limits dollar that for limits group consumers for and group individual have and individual sufficient health health access insurance to insurance coverage medical coverage benefits are $2 million throughout are for $2 policy million the years annual for beginning policy term of years on the or beginning policy. after September Restrictions or 23, after for 2012, September annual but dollar before 23, limits January 2012, for but group 1, before and Restrictions January individual 1, health for annual Restrictions insurance dollar limits coverage for for annual student are dollar health $2 limits million insurance for for student policy coverage health years are insurance beginning $500,000 coverage for on or policy after are years September $500,000 beginning 23, for policy 2012, on or years but after before beginning September January on 23, or 1, after , September but Restrictions before January 23, for 2012, annual 1, but dollar before Your limits student January for health student 1, insurance health Your student insurance coverage health includes coverage insurance are annual $500,000 coverage limit for includes of policy $500,000 an years annual per beginning condition limit of on $ per on or all after policy covered September year during services, 23, the including plan 2012, year but on essential before all covered January health services, benefits. 1, including Other Your internal student essential maximums health insurance benefits. (on essential coverage Other internal health includes benefits maximums an annual and certain (on limit essential of other $ on services) all health covered benefits are services, described and certain including more other fully essential in services) the benefits health are described benefits. chart included Other more inside internal fully this the maximums plan benefits summary. (on chart essential If included you health have inside any benefits questions this and plan certain or summary. concerns other If about services) you have this are any notice, described questions contact more concerns fully in the about benefits Be this advised notice, chart that included contact you may inside be this eligible plan summary. Be for advised coverage If that you under you have may a any group be questions eligible health for plan concerns coverage of a parent s about under a this group employer notice, health or contact plan under of a parent s employer individual Be or advised health under insurance a that parent s you policy may individual be if eligible health you are for insurance under coverage the policy under age if you of a are group 26. under Contact health the age plan the of of plan 26. a administrator parent s Contact the employer plan of administrator the under parent s a parent s of employer the parent s individual plan employer health or the plan insurance parent s or the individual policy parent s if individual health you are insurance health under insurance issuer the age for issuer more of 26. information. more Contact information. the plan administrator of the parent s employer plan or the parent s individual health insurance issuer for more information.

7 Important Note General Notice: Any person who knowingly and with intent to injure, defraud or deceive any insurance company or other person files an application for insurance or statement of claim containing any materially false information or who conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties. International student waiver submissions may be audited by Rochester Institute of Technology, Waiver Aetna Student submissions Health, may and/or be audited its contractors by Rochester or representatives. Institute of Technology, You may be Aetna required Student to provide, Health, and/or upon request, its contractors any coverage or representatives. documents and/or You other may records be required demonstrating to provide, that upon you request, meet the any coverage school s requirements documents for and/or waiving other student records health demonstrating insurance plan. that By you submitting meet the waiver school s requirements request, you agree for waiving that your the student current health insurance insurance plan may plan. be By contacted submitting for the confirmation waiver request, that you agree your coverage that your is current in force insurance for the plan applicable may be policy contacted year and for confirmation that it meets that the your school s coverage waiver is in force requirements. for the applicable policy year and that it meets the school s waiver requirements. Please make sure you understand your school s credit hour and and other requirements for for enrolling in this plan. Aetna Student Health reserves the the right right to to review, review, at any at any time, time, your your eligibility eligibility to enroll to in enroll this in plan. this If plan. it is If determined it is determined that that you you did did not not meet meet the the school s eligibility requirements for for enrollment, your your participation in the in the plan plan may may be be terminated or or rescinded in in accordance with its terms its terms and and applicable law. law. This material is for information only. Health benefits and and insurance plans contain exclusions, benefit maximums and limitations. The plan will pay benefits in in accordance with with any any applicable insurance law. If any discrepancy exists between this pamphlet and and the the Master Policy/Group Agreement, the Master Policy/Group Agreement will govern and and control the the payment of of benefits. Information is believed to be accurate as of the production date; however, it it is is subject to to change. Policy forms issued in OK include: GR

8 How much does it cost? Annual Spring Coverage 8/15/13-8/14/14 1/15/14-8/14/14 Student Only $1248 $725 Spouse $2477 $1439 Child(ren) $2007 $1166 How and when do I enroll in the plan? RIT Participation requires all in students Rochester to Institute have adequate of Here's be billed when semi-annually you have to based sign on up their active medical Technology s How much insurance. Student does it Health cost? Insurance Plan Enrollment registration and status. Waiver All other deadline international dates: Domestic is required students by your school may voluntarily for all eligible elect fulltime undergraduate in the plan by: students, Annual Fall to students wishing to enroll should download enroll and - fill 9/30/13 unless they are out the application Spring found at www. Going covered Coverage Online under at another comparable 8/15/13-8/14/14 plan. Spring universityhealthplans.com. - 2/27/14 1/15/14-8/14/14 Students Proof of comparable have the option coverage, to either in accordance put the Please note that enrollment deadlines Only $1248 $725 charge with your on school s their RIT requirements, student account must or be and termination dates may vary for payment completed Spouse can and be returned made online to Rochester $2477 with a credit international students. $1439 card. Institute Please of Technology review the requirements each academic below: year Child(ren) $2007 Dependent Coverage $1166 by the enrollment deadlines. Domestic Students Eligible students who enroll may also cover RIT requires all domestic students to have their eligible dependents. The coverage adequate medical insurance. If a student period must be concurrent with the insured does How not and have when coverage, do I this enroll requirement in the plan? student s. may be satisfied by enrolling for Basic Participation in Rochester Institute of Here's when you have to sign up Accident & Sickness coverage. Technology s Student Health Insurance Plan Enrollment and Waiver deadline dates: International is required by your Students school for all eligible fulltime undergraduate students, unless they are All matriculated, RIT International students Fall - 9/30/13 on covered A, B, E, under F,G, I, another J, K, O, Q, comparable R and V visas plan. will be Spring - 2/27/14 automatically Proof of comparable enrolled coverage, in RIT s Aetna in accordance Student Health with your Plan. school s These requirements, international students must be will completed and returned to Rochester Institute of Technology each academic year by the enrollment deadlines.

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10 Aetna Student Health c/o Communications Dept. 200 Rivers Edge Dr. Medford, MA Aetna Inc (5/13)