Student Health Insurance Plan
The North Dakota University System (NDUS) is pleased to offer health insurance coverage to NDUS students through United Healthcare insurance company. Domestic students (i.e. American citizens) are not required by the NDUS to carry this coverage, and we know many of you may be covered by your parents' insurance until age 26. However, the Affordable Care Act does require that you carry some sort of health insurance, and this plan is an option.
FREQUENTLY ASKED QUESTIONS
Am I required to have this Student Health Insurance Plan?
International students (F, J and M visas) are required to have this student health insurance plan per State Board of Higher Education Policy. Citizens of Canada and Norway (whose home country health insurance provides coverage internationally) are exempt from this policy. Domestic students (i.e. American citizens) are not required to have this plan by the State Board of Higher Education or NDUS. However, the Affordable Care Act does require that all eligible Americans have at least basic health coverage.
Am I eligible to enroll in this Student Health Insurance Plan?
To be eligible for this plan you must meet at least one of the following criteria at the time of enrollment:
- Full-time student status and attend at least one class physically on campus each fall and spring term, or
- Full-time graduate student status enrolled in:
International student enrolled at an NDUS institution and maintaining their F, J or M immigration status
- 9 credits each fall and spring term, or
- UND student enrolled in 6 credits and a 20-hour per week graduate assistantship each fall and spring term, or
- NDSU student enrolled in 5 credits and a 20-hour per week graduate assistantship each fall and spring term, or
- NDSU student whose Certification of Enrollment Status, approved by the Graduate School, confirms the student's full-time status.
Is my spouse and/or dependent(s) eligible?
Yes. Your current spouse and/or dependent(s) are eligible and enroll at the same time that you do. See "How do I enroll?" below for instructions on how to enroll your spouse and/or dependents. Spouses and dependents are eligible after the initial enrollment period:
- On the date you marry your spouse, or
- On the date you acquire your dependent.
What are my enrollment options?
International students are automatically enrolled by semester in the student health insurance plan by their institution. The premium cost is billed to international student's campus connection account.
Domestic students must enroll on their own under the following options:
Fall enrollment: July 17, 2015 through September 15, 2015.
Spring enrollment will begin in December 2015.
- Annual year: August 16, 2015 - August 15, 2016; or
- Fall semester: August 16, 2015 - December 31, 2016.
Premiums must be paid at the time of enrollment.
- Spring/summer semester: January 1, 2016 - August 15, 2016.
What is the premium cost for each enrollment period?
Premium costs are per person (student, spouse or dependent) for the designated enrollment period.
Annual year (August 16, 2015 - August 15, 2016): $2,364
Fall semester (August 16, 2015 - December 31, 2015): $891
Spring/summer semesters combined (January 1, 2016 - August 15, 2016): $1,473
When do I have to pay the premium?
Domestic students: You are required to pay the premium for yourself and your spouse and/or dependent(s) for the time period you have selected, in full, at the time of online enrollment.
International students: Your premium will be charged to you on your campus account. You are required to pay the premium to your campus, in full, no later than the end of the sixth week of a regular fall or spring term. (See NDUS Procedure 505 for more information). If you have a spouse and/or dependent(s) whom you wish to enroll, their premium must be paid directly to UnitedHealthcare once enrollment is finalized.
I need access to my Financial Aid before I can pay the premium - what do I do?
1. Email Karen Lesch at: email@example.com
2. Email subject line: Financial Aid/Student Insurance Purchase
3. Copy and paste this into the body of your email:
"My name is FIRST LAST. It is my intention to purchase the Student Health Insurance plan as soon as my financial aid is disbursed and before the deadline of September 15, 2015. My understanding from the Director of Student Affairs at the North Dakota University System office is that my effective date will be August 16, 2015."
How do I enroll myself and/or my spouse/dependent(s)?
Domestic students: Enrollment is done on United Healthcare's website. Follow these steps:
1. Go to United Healthcare's website
2. Select your school from the list in the center of the page
3. On the next screen, follow the directions on the right to enroll now for yourself and your spouse and/or dependent(s).
4. Need help? Contact United Healthcare's customer service at 1-877-433-6667 or firstname.lastname@example.org
International students: Your school will provide United Healthcare with your information and you will be automatically enrolled. You do not need to go online to enroll.
If you have a dependent and/or spouse whom you would like to enroll, please follow the steps below. Please note that dependents cannot be added until the international student's enrollment has been processed.
1. Go to United Healthcare's webpage for NDUS institutions
2. Select your college or university
3. Scroll down and select "Dependent Enrollment (For dependents of International students and Graduate Assistants)"
4. Fill out the enrollment form
4. Need help? Contact United Healthcare's customer service at 1-877-433-6667 or email@example.com.
There is a student health center on my campus, do I need a referral if I want to be seen somewhere else?
Unless your student health center is closed (e.g. the weekend, over summer break) or it is an emergency, yes, you do need a referral. To receive a referral, contact the student health center on your campus.
Why does United Healthcare need my Social Security Number (SSN)?
United Healthcare will request your Social Security Number so they can generate the form you will need for your 2015 taxes to prove your insured status as required by the Affordable Healthcare Act. International students do not need to provide a Social Security Number.
How does this plan compare to others?
According to the metallic band ranking system used in the Health Care Marketplace, the NDUS student health insurance plan is a platinum plan. However, the premium cost of the plan is significantly lower than comparable platinum plans on The Marketplace Exchange. Because this insurance plan is for students only (who typically have fewer health issues) and because the entire NDUS is participating, UnitedHealthcare is able to offer a lower premium.
Is this student health insurance plan compliant with Affordable Care Act (ACA)?
Yes! UnitedHealthcare will provide you with the necessary documentation needed for your 2015 taxes to prove your insured status.
I turn 26 in a couple of months, do I have to sign up now or can I wait until then?
To avoid a lapse in coverage, you should enroll now. Once the enrollment period has ended, you are not able to enroll until the next scheduled enrollment period unless you have a qualifying life event.
Can I extend my coverage if I no longer meet the eligibility requirements (past graduation, dropped below minimum class load, etc.)?
Yes. If you have been continuously insured under the school's regular student policy for at least three consecutive months, you're eligible to continue your coverage for a period of not more than 90 days past the termination date under the school's policy. If that continuation term runs into the next policy year, you must purchase coverage under the new policy chosen by the school. To enroll, fill out the Continuation Enrollment Form under your institution at uhscr.com/ndus and mail it to United Healthcare with your premium payment.
When will I receive my insurance card?
You can access your card through your online account. Once you are enrolled, you will be asked to create an online account. Through your account, you can access your card in a variety of ways: it can be printed, emailed, faxed or you can download a smartphone app which allows you to show your card right on your phone. The smartphone app also allows you to email or print your card right from your phone. You can also request a hard copy of your card to be sent to you from United Healthcare.
United Healthcare sent me a letter asking me to go to my school's registrar's office. Why?
United Healthcare is using this letter to verify that you meet the eligibility requirements for this student health insurance plan.
What benefits does this plan offer?
If you are already enrolled, we encourage you to sign in to your United Healthcare account to review your personal benefits.
If you are not yet enrolled, you are welcome to view the summary of benefits brochure on the United Healthcare website. Select your school, and choose the appropriate brochure.
Are intercollegiate sports injuries covered?
Yes. There is a separate policy that provides coverage for intercollegiate sports injuries, including injuries that happen during practices. For more information, please contact United Healthcare at: 1-877-433-6667 or firstname.lastname@example.org
My sport begins before the fall semester coverage. How do I get early enrollment?
To enroll in coverage for August 1 - August 15, students athletes have two options:
1. Contact their SHIP campus contact (listed below). Fill out the early enrollment form and mail it in with payment to United Healthcare. Coverage will be effective on the date United Healthcare receives the form and payment.
2. Call United Healthcare's customer service line (1-877-433-6667) and request to be transferred to the "Eligibility Department" for assistance with enrollment. You will be asked to provide the necessary personal information and then be emailed a payment link. The coverage will be effective as soon as you complete the payment link.
Please note, this coverage only runs through August 15. You will also need to enroll for fall semester or annual year to maintain coverage.
What is the cost of prescriptions?
The prescription drug benefits works on a three tier system. Prescriptions are categorized into three different tiers and each tier has a specific co-pay cost (the cost to you when you purchase your prescription). Tier One prescriptions are $10, Tier Two prescriptions are $30, and Tier Three prescriptions are $50. To see which tier your prescription fall under, please view the Prescription Drug List through your online account. The Prescription Drug List is divided by categories of conditions that the prescription is used for. You may also search for your prescription name alphabetically using the index at the back of the document.
What is the deductible?
The deductible, or the amount of medical expenses you are required to pay before United Healthcare will begin paying for expenses, is $100 for a single individual, or $200 for a family seeing a preferred provider. For out of network providers, this cost is $500 per person. Once you have paid this expense you will have "met your deductible" and United Healthcare will begin providing medical expense coverage.
A preferred provider is a physician or facility that is considered in-network under this student health insurance plan.
This is a once per policy year cost to you. Once you have met your deductible, you will not have to pay the deductible again until the next policy year.
How do I know if my providers are in-network?
United Healthcare provides health insurance throughout the U.S. which means that many providers throughout the country are in-network under your plan. To search for your specific provider, pharmacy, clinic, etc., please follow these steps:
1. Go to United Healthcare's Find a Physician or Facility webpage
2. Select the type of physician or facility you're looking for. Then type in the name, facility, specialty or condition in the "New Search" box or click on any of the options under "Physician Specialties, Facilities, or Conditions"
What is the medical expense coverage?
Once you have met your in-network deductible, United Healthcare will pay for 80% of your in-network medical expenses unless otherwise noted in your Schedule of Benefits Document, which can be found in your United Healthcare account. For example, if you have met your deductible and you were seen by an in-network provider in your community and were billed $145 for that visit, United Healthcare will pay for 80% of that bill, or $116. You will be responsible for the remaining 20%, or $29.
Once your out-of-network deductible has been met, United Healthcare will pay for 60% of your out-of-network medical expenses unless otherwise noted in your Schedule of Benefits Document.
What is the maximum out-of-pocket expense?
The maximum out-of-pocket, or the maximum amount of medical expenses you will be required to pay within one policy year is $5,000 for a single individual's in-network medical expenses, or $10,000 for a family's in-network medical expenses.
The maximum out-of-pocket expense for out-of-network medical expenses is $10,000 for a single individual, or $20,000 for a family.
This means that if the medical expenses you are required to pay (see "What is the medical expense coverage"?) reach the amount outlined above within one policy year, United Healthcare will cover 100% of your medical expenses for the rest of that policy year.
I am currently pregnant, what all is covered?
If you are already enrolled, we encourage you to sign in to your United Healthcare account to review your personal benefits.
Who do I contact on campus if I have questions about enrollment?
Campus contacts are as follows:
Bismarck State College
Dakota College at Bottineau
Dickinson State College
Lake Region State College
Mayville State University
Minot State University
North Dakota State College of Science
North Dakota State University
Sara Johnson - International
Terri Porter - Domestic
University of North Dakota
Kim Wickersham - Domestic Graduate Assistants
Colleen Hutchinson - International
Valley City State College
Williston State College
Who can I contact with questions about my benefits?
You are welcome to contact United Healthcare's customer services: 1-877-433-6667 or email@example.com
Where can I find additional information?
Visit the United Healthcare Website www.UHCSR.com/NDUS.