Kutztown University: Health & Wellness Center

Student Health Insurance August 2011- August 2012

YOU MUST HAVE A HEALTH RECORD ON FILE AND HAVE PAID THE SEMESTER HEALTH CENTER FEE IN ORDER TO ENROLL IN THIS PLAN!!!

International Students Health Insurance Requirements

STUDENT ACCIDENT & ILLNESS INSURANCE PLAN
PLAN ADMINISTRATOR: CONSOLIDATED HEALTH PLANS

ELIGIBILITY

A student is eligible for enrollment in the university health insurance if he/she has:

Applied before the enrollment deadline (visit the website at www.chpstudent.com for details)
Enrolled for coursework (6 credit minimum for undergraduate students) and actively attended class for the first 31 days after coverage begins
Completed the required medical forms (only done once, usually during the first semester of attendance)
Been assessed the health center fee for the term of enrollment

Please contact Health Administrative Services (610-683-4082, Option 2, Option 2) if you have any concerns about meeting these requirements. The processing of your enrollment will be delayed if you have not submitted all appropriate paperwork and paid all semester fees.

MEDICAL COVERAGE

Please carefully review the Benefit Summary to make sure the plan meets your healthcare needs. There are some limitations and exclusion. It is the individual's responsibility to become familiar with plan benefits. The network provider is pending for next year. Current network providers may be viewed at www.mycignaforhealth.com.

HOW TO ENROLL

International students automatically are enrolled in the university plan unless proof of a private plan is approved by the Medical Records Manager.
All other students should visit the website, (www.chpstudent.com) website, where they can download more plan information and enroll on-line, if desired. If using the conventional mail system, the enrollment card and premium are sent directly to Consolidated Health Plans, not KU.

PREMIUM RATES, EFFECTIVE & TERMINATION DATES for 2011-2012

TERM	PREMIUM	DATES
Annual plan	$1223	August 9, 2011 - August 8, 2012
Fall plan*	$417	August 9 - December 31, 2011
Spring/Summer plan*	$849	January 1 - August 8, 2012
Summer	$443	May 3 - August 8, 2012

*Consolidated Health Plans sends renewal notices to students who have enrolled in the annual plan. No notices are sent to students who have enrolled for a partial period.

Students who will be terminated from a current private health insurance plan due to age restrictions, etc., may enroll in the plan beyond the enrollment deadlines. Those individuals must provide a certificate from their current health plan within 30 days of termination confirming health coverage and pending termination date. Contact Ruthann Carter for pro-rated amounts at 800-633-7867, x 123.

BENEFIT PROCEDURE

In the event of injury or sickness, the student must: 1. Report to Clinical Services for treatment or an initial evaluation. Clinic hours are Monday - Thursday, 8 a.m. - 7:30 p.m., Fridays, 8:00 a.m. - 5:30 p.m., weekends 10:00 a.m. to 5:30 p.m. If the clinic is closed or you are more than 30 miles away from the university, you may secure treatment at the nearest hospital or physician. 2. The preferred provider organization with this policy is Cigna/Great-West Healthcare. Always confirm that the provider still participates with the preferred provider organization. If you do not use a network provider, you will have to pay for the services and submit a claim form for reimbursement (available in Health Administrative Services or may be downloaded from the Consolidated Health Plans Web site).