Student Health Insurance Plan



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2013-14 Student Health Insurance Plan A student health insurance plan customized for you. Act now enrollment and waiver deadlines apply! Brought to you by the University of Connecticut and Consolidated Health Plans School Policy Information 2013-2014

Dear Student/Parent/Guardian, The University of Connecticut requires all full-time students to maintain health insurance coverage. Specific details as to the definition of full-time student, program eligibility, coverage, Student Health Services usage and fees, and waiver requirements can be found at www.shs.uconn.edu/insurance.html. In order to assist students in maintaining appropriate and cost effective coverage, the University sponsors a student health insurance plan. The 2013-2014 school year marks the partnership of the University with Consolidated Health Plans (CHP) as the plan administrator and the nationwide provider network of Cigna. This partnership with the CHP/Cigna team presents the students with an affordable plan while maintaining the high level of coverage that the university has been proud to provide for the past two years. The costs and coverage found within this student health insurance plan merit your serious consideration, as an opportunity may exist to save money while providing students with a comprehensive health insurance option with neither pre-existing condition clauses nor annual limits. It is strongly recommended that you compare the CHP/Cigna plan against other coverage you might currently have to determine if your student s insurance benefits are available for services performed while away at school. Many carriers have specific rules related to out-of-network care that could significantly increase your out of pocket costs. Additionally, many plans, regardless of network status, have high deductibles that must be met before any benefits will be paid. The CHP/Cigna plan has a $250 deductible per plan year for in-network care and neither a deductible nor co-payment for services provided by UCONN Student Health or UCONN Counseling and Mental Health Services. If after review of the coverage a student wants to formally decline (waive) the CHP/Cigna Student Health Plan, an online waiver must be completed. The online Waiver is accessed through the student administration (PeopleSoft) system at www.studentadmin.uconn.edu. A seven-digit PeopleSoft ID number and unique password are needed to access the system. The only acceptable form of notification to decline the coverage is via the online waiver. Failure to complete the online waiver prior to the 9/15/2013 deadline will result in automatic enrollment and a charge of $2338.00 being placed on the student fee bill. Please call Bailey Agencies, Inc. 860-446-8255 or 800-321-4449 if you have any questions about the CHP/Cigna Student Health Plan. Sincerely, Michael Kurland Director, Student Health Services

Student Health Insurance Plan at a Glance Here is a brief description of the Student Health Insurance Plan. Note that these are only a few of the benefits offered by UConn: Aggregate Benefit Maximum Pharmacy Maximum Mental Health Maximum Outpatient Maximum Pre-existing Conditions Preventative Care Out-of-Pocket Maximum Policy Year Deductible (per person) (Waived at UConn/SHS) Inpatient Hospital Expense (Pre-certification requirements apply) No Exclusions Covered at 100%, no Deductible In-Network $5,000, per policy year Out-of-Network $250 $500 90% of PA Physician s Office Visit (Co-pay waived at UConn/SHS) Mental Health Office Visit (Co-pay waived at UConn/CMHS) $25 Per visit co-pay, $25 Per visit co-pay, Emergency Room Expense $150 co-pay per visit, $150 co-pay per visit, (Co-pay waived if admitted) 100% of Recognized Charge Walk-in Clinic Expense (Co-pay waived at UConn/SHS) Urgent Care Expense $25 co-pay per visit, $25 co-pay per visit, X-Ray and Laboratory Expenses (Laboratory expense not subject to deductible) Prescription Drug Benefits (Express Scripts Network www.express-scripts.com) 90% of PA 70% of U&C $15 co-pay for Generic Drugs $0 co-pay for Generic Contraceptives $30 co-pay for Brand Name Drugs PA = Preferred Allowance R&C = Reasonable and Customary Please Note: MOST services at UCONN/SHS are provided at no additional cost. Only UCONN Storrs Campus Students are eligible to use the SHS. The Plan will pay benefits in accordance with any applicable Connecticut insurance law. The UConn Student Health Insurance Plan may not cover all your health care expenses. The plan excludes coverage for certain services and contains limitations on the amounts it will pay. Please read the UConn brochure carefully before deciding whether this plan is right for you. While this document and the Student Health Insurance Plan will tell you about some of the important features of the plan, however; other features may be important to you. If you want to look at the full plan description, you may view it online at: www.chpstudent.com/uconn. Cost and Effective Dates of Coverage ANNUAL SPRING (8/15/13-8/14/14) (1/1/14-8/14/14) Student* $2,338 $1,472 One Dependent (additional to student) $4,048 $2,532 Family (additional to student) $6,476 $4,051 * Student Premium includes a University Administration Fee

Why is student health insurance important? Health care costs are at an all-time high. Don t let an unexpected trip to the doctor or hospital set you back financially. Here are some things to think about: Take a look at the University of Connecticut Student Health Insurance Plan and compare it to your current coverage. Look at premiums, deductibles, benefits provided and the dates of coverage. You re covered for as long as you are registered with the University of Connecticut as a full-time student. The UConn Plan covers you away from home or abroad. If you travel in the U.S. or study abroad, it s good to know you re covered if you need health care. The UConn Plan includes prescription drug coverage. The cost of prescription drugs is growing by double digits. Under our Plan, you pay low co-payments for prescriptions at in-network pharmacies. Where can I go for services? UCONN/Storrs Students should consider Student Health Services their first stop. SHS can provide many of the routine health services you need and most often at a reduced out of pocket expense to you. Whether you are a Storrs campus student or attending one of our Regional campuses, you may also visit any licensed health care provider for covered services by using the Cigna PPO network. To find a complete listing of GWH-Cigna PPO providers, go to www.mycignaforhealth.com or contact Consolidated Health Plans at 413-733-4540, toll free at 800-633-7867, or www.chpstudent.com/uconn for assistance.

How do I waive or accept the student health insurance? Most full-time students will be automatically enrolled in the Student Health Insurance Plan, unless a waiver has been completed by the specified deadline dates listed. The premium for the Plan will be added to your tuition bill. Eligible students who enroll may also insure their eligible dependent(s). To enroll dependent(s), please contact the Bailey Agencies Inc., 15 Thames Street, Suite 100, Groton, CT 06340, 860-446-8255 or 1-800-321-4449. Note: The following programs are excluded from automatic enrollment but may enroll directly with the Bailey Agencies if eligibility requirement is met: Executive ED Program, Executive MBA, Graduate Assistants, Interinstitutional Programs, Masters of Engineering, Masters in Public Administration, Masters in Public Health, MS in Accounting, Non-Degree Programs, Teacher s Cert. Program, Hartford, Stamford, Waterbury MBA. If after review of the coverage a student wants to formally decline (waive) the CHP/Cigna Student Health Plan, an online waiver must be completed. The online Waiver is accessed through the student administration (PeopleSoft) system at www.studentadmin.uconn.edu. A seven-digit PeopleSoft ID number and unique password are needed to access the system. The only acceptable form of notification to decline the coverage is via the online waiver. The deadlines to waive coverage are: Fall/Annual Plan - September 15, 2013 Spring Term (new students only) - February 05, 2014 If you submit an online waiver for the Fall Semester, coverage is automatically waived for the Spring semester; you don t need to submit the waiver again. Only new or transfer students need to complete the online waiver request for the Spring semester. Waiver submissions may be audited by the University of Connecticut, the Bailey Agencies, and/or their contractors or representatives. You may be required to provide, upon request, any coverage documents and/or other records demonstrating that you meet the school s requirements for waiving the student health insurance plan. By submitting the waiver request, you agree that your current insurance plan may be contacted for confirmation that your coverage is in force for the applicable policy year and that it meets the school s waiver requirements.

Student Health Services 234 Glenbrook Road, Unit 4011 Storrs, CT 06269-4011