Insurance Waiver

As a non-academic condition of enrollment all graduate and professional students are required to have health insurance coverage in effect at all times while enrolled at UC San Francisco. All registered students are covered under the UC Graduate Student Health Insurance Plan unless they have applied and have been approved for a waiver.

The UC Graduate Student Health Insurance Plan augments the care available through UCSF Student Health and Counseling and provides coverage for medical, dental, and vision care services.

The insurance waiver site for the Spring 2012 quarter is now open. If you were a new or re-enrolled student who was approved for a waiver in the Summer 2011, Fall 2011 or Winter 2012 you do not need to re-apply. An approved waiver is valid through the end of the Summer 2012 quarter so long as you maintain continuous coverage under your plan. Students will need to re-apply for a waiver for Fall 2012.

Students who speak English as a second language and have questions related to opting out of the graduate student health insurance plan may contact 476-1281. A staff member will be happy to talk you through the process.

NOTE: All registered students, regardless of waiving the Student Insurance Plan, will have access to services provided at Student Health & Counseling Services.

• Eligibility Required
• Deadlines
• Application
• Verification Process
• Process for Adjusting Fees
• Appeals Process
• Loss of Coverage
• Should I waive?

Eligibility Required

Students who have access to an employer-sponsored insurance plan or an individual plan with a minimum of 6 months of continuous coverage that meet all minimum benefit levels will be eligible to waive the Student Insurance Plan. The minimum benefit requirements include:

• US owned company headquartered and operating in the US.
• Have a facility providing full services within 30 miles of program location or 30 miles of residence while participating in program.
• Plan year minimum benefit: $250,000 per year; or aggregate lifetime maximum of $1 million or greater.
• Annual Deductible: $2,500 or less.*
• Out-of-pocket expense cap per year: $5,000 or less.
• Inpatient: Coverage at 60% or higher.
• Outpatient: Coverage at 60% or higher.
• Mental Health coverage: Inpatient and outpatient benefits must be offered as part of your health insurance plan.
• Prescription coverage: Ability to fill a prescription written by a local physician; pharmacy access nationwide.
• Geographic area covered: All medically necessary care - State of CA (minimum area), Emergency care - world wide.
• Must stay in effect at all times while participating in program.

* Deductibles may be higher if you have a Health Savings Account (HSA)

Students having medical coverage through the Veterans Administration or Medi-Cal may apply for the waiver subject to service levels meeting the minimum benefit requirements. Medi-Cal applicants must demonstrate a history of at least six months of eligibility.

Deadlines

Students will be allowed to apply for a waiver commencing the beginning of Fall, Winter, or Spring quarter. Waivers cannot be applied mid-term and will not be processed for continuing students in summer term. Only new and re-admitted students will be allowed to apply for a waiver in the summer.

SHCS will conduct a waiver application and verification process for new waivers on the following schedule:

Application

To apply for a waiver go to the 'My Health' tab in the Student Portal and click on the 'UC SHIP Waiver Application' link. The deadline to submit an application for the Spring 2012 quarter is Thursday, March 22nd at 11:59pm.

Applications are accepted fall, winter and spring terms. Students will need to reapply each academic year by the applicable deadline for the term in which they wish to be granted a waiver. There is a $20 application processing fee. This application fee will be collected via the registration process.

You will need the following to begin the application process:

• MyAccess ID and password
• Insurance company contact information
• Insurance policy group number, member ID, and summary of benefits

As part of your application you agree to provide a copy of your health insurance identification card or other documentation as requested by the University, its agent or the Insurance Company. Failure to provide documentation upon request, the University will have the right to enroll you in the Student Health Insurance Plan and the appropriate fee will be charged to your student account.

Verification Process

SHCS will verify waiver applications for all terms. SHCS will also verify all students with waivers a second time at some point during the year to ensure all policies are still in effect.

If SHCS is unable to verify a student’s plan prior to the approval deadline or if SHCS is informed at any point that a student’s plan has terminated, SHCS may at any time re-apply the full insurance fee for the term in question.

Process for Adjusting Fees

Students should NOT PAY THEIR FEES until their waiver application has been processed. The insurance premium will be removed from the student’s fees and the application fee applied once the waiver application is fully processed and approved. No refunds will be processed through the Registrar’s Office if a student pays their fees prior to their waiver application approval.

If you have applied to waive, do NOT PAY YOUR FEES until you have received confirmation from SHCS about your application status.

Appeals Process

If a student’s application for waiver is denied, they may file an appeal with Student Health and Counseling Services by submitting the Insurance Waiver Appeal Form. Appeals must be submitted within 5 days of the date of the denial notice.

Loss of Coverage

Students are required to maintain continuous coverage under an approved health insurance plan or the Student Insurance Plan at all times while enrolled at UCSF. Students may elect at the beginning of any term to cancel their approved waiver and enroll in the Student Insurance Plan.

If a student loses coverage under their health insurance plan mid-term the student must submit to the University an Insurance Waiver Reversal Form. If the form is received after thirty (30) days from the start of the quarter the effective date of coverage will be the date the form was signed. The student must pay the entire premium for the term in which they are electing to enroll. Mid-term enrollment does not allow for any proration of the premium.

If a student wishes to enroll at the start of a new term, the student must submit to the University an Insurance Waiver Reversal Form. If the form is received within thirty (30) days of the start of the quarter the effective date of coverage will be the quarter start date. The student must pay the entire premium for the term in which they are electing to enroll.

Should I Waive Coverage?

To waive, or not to waive? To answer this question, please review the information below to help you decide.

The reason health insurance is a mandatory condition of enrollment is to ensure (a) you have access to medical care anytime you need it, (b) you will not experience a financial catastrophe in receiving the care you need and (c) you have the help you need to avoid compromising your academic progress.

The Student Health Insurance is an affordable health insurance plan tailored to the health care needs of UC San Francisco students. It features year-round, world-wide coverage using the Anthem PPO network; this means students can receive convenient, high quality care when they are sick or injured. Included in the student insurance plan is dental coverage through Delta Dental and vision services through EyeMed Vision Care. The Student Health Insurance Plan provides comprehensive coverage for all your healthcare needs.

Even if you waive the Student Insurance Plan, you will still have access to Student Health and Counseling Services. Those services include:

• Primary Care
          • Labs ordered by a SHCS provider to Quest Diagnostics
          • Physical Exams & Pap smears
• Counseling and Psychological Services
• Traveler's Health
• Wellness Programs & Outreach

The Student Insurance Plan is designed to "complement" the services offered at Student Health and Counseling. It provides benefits including emergency/after hours care, hospitalization, surgery, specialized care not provided at Student Health and Counseling, specialized testing, e.g. CT scans or MRI's. It would be ideal if your private plan did the same, without you having to leave the campus area.

Please see the links below highlighting the medical, dental, vision, and prescription benefits of the Student Insurance Plan. Compare to your alternative plan to see what works best for you and your family.

• Medical Benefits
• Dental Benefit
• Vision Benefits
• Prescription Benefits

If you have additional questions, please contact us.