Student Health Insurance Plan – Waiver Standards Effective Fall 2020
The University System of Georgia (USG) sponsored injury and sickness Insurance plan will be administered by UnitedHealthcare StudentResources (UHCSR) for the 2020-21 academic year. The insurance plan is underwritten by UnitedHealthcare Insurance Company. For the upcoming academic year, UHCSR will be enforcing the following waiver standards.
Domestic Student Waiver Standards – Mandatory Categories
In order to be eligible to waive out of the USG SHIP, the student must be enrolled in an ACA compliant plan.
International Student Waiver Standards
In order to be eligible to waive the student insurance plan, the student’s existing insurance plan must meet the following 3 requirements and the requirements in either I, II, III, or IV below.
Coverage includes effective dates spanning the entire period for which the waiver is requested. Summer - 06/01/2021 through 07/31/2021 Fall - 08/01/2020 through 12/31/2020 Spring - 01/01/2021 through 05/31/2021
Plan must cover Repatriation and Medical Evacuation, or coverage should be purchased separately to supplement the Health Plan used to waive off of the SHIP.
If a fully insured plan, the plan must be approved as a health insurance plan by the State Insurance Department (Travel Policies, Disability policies, Hospital Indemnity, Accident Only Policies, and other limited benefit polices are not acceptable).
I. Plan Description
Plan is ACA compliant, meaning that the plan is an individual or group insurance plan meeting the requirements of ACA. a. Unlimited Maximum Benefit for covered medical expenses. b. Coverage for essential benefits (with no dollar limits), as defined under the ACA. This includes, but is not limited to: Pharmacy Mental health services on parity with medical services Maternity benefits Preventive care with no cost-sharing for Preferred Providers Coverage for pre-existing condition with no waiting period Pediatric dental and vision coverage
Maximum preferred provider total out-of-pocket expenses cannot exceed $8,150 per member ($16,300 per family). This amount will be adjusted annually to reflect the then current allowable maximum out-of-pocket.
For students with J Visas, waiver eligible coverage must meet the State Department’s J Visa Insurance Standards including, but not limited to, the requirement that the plan have a deductible not to exceed $500.
II. Coverage is provided under an employer-sponsored group plan that is ACA compliant as described above. In this case, it is likely that the insured may supplement the Health plan with separate Repatriation and Medical Evacuation coverage.
III. A plan provided to sponsored students (for example: Saudi Arabia Cultural Mission, Kuwait, etc.) that is backed by the full faith and credit of the student’s home country may be acceptable.
The plans will be reviewed and a determination made regarding comparability to the USG Plan, and if determined to be comparable or better, will be accepted.
IV. A plan provided by a pre-approved United States Cultural Exchange Program; e.g., Fulbright Programs, etc.
NOTE: The above international student waiver standards apply to the Research and Comprehensive Schools. These also apply to the State Colleges and Universities with the exception that International Students at the State Colleges and Universities are allowed to waive off with the USG-sponsored PGH Plan. Mammography, PAP Smears, Prostate Specific Antigen (PSA) Tests, Chlamydia Screening, Mastectomy, Bone Mass Measurement, Colorectal Cancer Screening, Dental Anesthesia, Diabetes, Surveillance Tests for Ovarian Cancer, Telemedicine, Drug Treatment of Children’s Cancer, Bone Marrow Transplants, Postpartum Care, and Mental Illness.
Students who already have comparable insurance coverage can apply to waive the insurance requirement. A comparable plan is one that meets the minimum requirements indicated in the above list. Your plan will be verified to determine if your coverage meets the minimum requirements. To apply for a mandatory insurance waiver go to: UnitedHealthcare StudentResources’ website search for your institutions name, and click continue. On the next webpage there will be a Waiver Form link for your institution.
WAIVER PERIODS ARE STRICTLY ENFORCED AT YOUR INSTITUTIONS!
Waivers are valid for one semester only!
Students will have to submit a new waiver each semester.
If you do not apply for a waiver or if your waiver is declined you will automatically be enrolled in the plan at the end of the waiver period and the cost of the policy will appear on your student account. WAIVERS MUST BE APPLIED FOR EACH SEMESTER.