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Premier Plan Frequently Asked Questions

In order to better serve you, the answers to most questions for enrolling into or waiving out of the Premier Plan can be found on this website. Below are the answers to the most frequently asked questions.

ENROLLMENT QUESTIONS:

• If I am charged for the Premier Plan, will I remain eligible for the Plan?
• I'm a full-time student scheduled to graduate in December, may I purchase the Premier Plan for the Fall Semester only?
• I will be eligible to enroll in another plan in November, can I purchase the Premier Plan from August 15 through November?
• Can I extend/continue my insurance for 6 months?

WAIVER QUESTIONS:

• I submitted my waiver, was it approved?
• If I waive the Premier Plan in the Fall can I change my mind and enroll in the Plan during the Spring Open Enrollment Period?
• If I waived the Premier Plan and then become involuntarily uninsured in the middle of the academic year due to age or employment, can I pick up the Premier Plan in mid-year?
• My son is covered under my plan as long as he is full-time at school, but he is dropping to part-time in the Spring. Can he enroll in the Premier Plan in the Spring?

BENEFIT QUESTIONS:

• Why was coverage for my Emergency Room visit denied?
• Are pre-existing conditions covered?
• Are medications to prevent pregnancy or procedures to prevent or terminate pregnancy covered?
• Are medications to prevent pregnancy covered when prescribed for treatment of a covered sickness?
• Does the Premier Plan provide coverage worldwide?
• Does the Premier Plan cover dental or vision care?

OTHER QUESTIONS:

• I've reviewed the materials on the website, but still have questions, who should I contact?

ENROLLMENT ANSWERS:

Q. If I am charged for the Premier Plan, will I remain eligible for the Plan?

A. To remain eligible for the Premier Plan, students must be enrolled in the required number of credit hours and actively attend classes for the first 31 days.

Q. I'm a full-time student scheduled to graduate in December, may I purchase the Premier Plan for the Fall Semester only?

A. No. The Premier Plan coverage term for eligible students who enroll in the Fall ends August 14, 2013. The coverage remains in effect after graduation and the coverage is worldwide. You may waive the Premier Plan with other coverage in effect until you graduate, as long as your other coverage meets GU's minimum requirements. To notify Student Health Insurance of these special circumstances, indicate in question #4 your graduation date when completing the waiver survey.

Q. I will be eligible to enroll in another plan in November, can I purchase the Premier Plan from August 15 through November?

A. No, the Premier Plan coverage ends August 14 of each Plan Year and prorated refunds are not granted. You may purchase other private "gap" coverage until the new insurance is in effect. To notify Student Health Insurance of these special circumstances, indicate in question #4 the termination date of your "gap" coverage when completing the waiver survey.

Q. Can I extend/continue my insurance for six months?

A. Students are eligible to voluntarily extend or continue their Premier Plan coverage for six months under the Continuation Plan provision if they were:

• Continuously insured in the Premier Plan on or before February 15, 2012 through August 14, 2012, and
• Are no longer eligible for the 12 month Premier Plan.

E-mail the Student Health Insurance Office for Continuation Plan information at . Continuation Plan payment must be received or post marked no later than August 28, 2012.

WAIVER ANSWERS:

Q. I submitted my waiver, was it approved?

A. Allow three business days before confirming if your waiver was approved. To confirm that your waiver has been approved, view your Student Account in MyAccess to see if a credit for the Premier Plan has been posted to your account. If the waiver is not approved, Student Health Insurance will send a request for additional information or an explanation for the denial to your GU e-mail address.

Q. If I waive the Premier Plan in the Fall can I change my mind and enroll in the Plan during the Spring Open Enrollment Period?

A. No, each student has only one Open Enrollment opportunity per Plan Year.

Q. If I waived the Premier Plan and then become involuntarily uninsured in the middle of the academic year due to age or employment, can I pick up the Premier Plan in mid-year?

A. Yes, as long as you enroll within 31 days of being "involuntarily dropped" and provide official written proof that you were involuntarily dropped from your other insurance due to age or employment. Please contact the Student Health Insurance for access to the online late enrollment form. The premium will be prorated for late enrollments.

Q. My son is covered under my plan as long as he is full-time at school, but he is dropping to part-time in the Spring. Can he enroll in the Premier Plan in the Spring?

A. If he is taking less than 9 credit hours (Undergraduate) or less than 8 credit hours (Graduate) in the Spring term, he will not meet the eligibility requirements. However, you may opt to enroll your son in your employer COBRA Plan. Otherwise, he should enroll in the Premier Plan in the Fall.

BENEFIT ANSWERS:

Q. Why was coverage for my Emergency Room visit denied?

A. Charges for Medical Emergency Expenses are covered only when the condition is a true Medical Emergency as defined in the Description of Benefits. If you have a non-emergent condition that needs to be treated after regular business hours:

• Contact the on-call Student Health Center physician at 202-444-PAGE for advice, or
• Go to a UHCSR Urgent Care center after hours. UHCSR Urgent Care centers can be found through the online provider search tool at www.uhcsr.com.

Q. Are pre-existing conditions covered?

A. Pre-existing conditions are covered if the condition or treatment is not specifically excluded or limited per the Exclusions and Limitations in Description of Benefits Booklet.

Q. Are medications to prevent pregnancy or procedures to prevent or terminate pregnancy covered?

A. No, medications and procedures for birth control are not covered. The following notice is required by the Patient Protection and Affordable Care Act:

NOTICE TO PLAN PARTICIPANTS
The organization that sponsors your health plan has certified that it qualifies for a temporary enforcement safe harbor with respect to the Federal requirement to cover contraceptive services without cost sharing. During this one-year period, coverage under your health plan will not include coverage of contraceptive services.

Q. Are medications to prevent pregnancy covered when prescribed for treatment of a covered sickness?

A. Yes, your health care provider can document the medical necessity and a medical override for non-contraceptive reasons may allow for insurance coverage. To purchase such medications with your Pharmacy Card, ask providers outside of the GU Student Health Center (SHC) to complete the Medication Override Form and fax it to Gallagher Koster Insurance Agency, 617-479-0860. Note: The SHC will submit the Medication Override for you.

Q. Does the Premier Plan provide coverage worldwide?

A. Yes, reimbursement for treatment outside the U.S. is paid according to Schedule 3 in the Schedule of Benefits Summary in the Description of Benefits Booklet.

Q. Does the Premier Plan cover dental or vision care?

A. No, the Premier Plan is a medical injury and sickness Plan. However, insureds have access to the Basix Dental Discount Network, which is linked on the Premier Plan Service web page. In addition, check Gallagher Koster's website to enroll in a voluntary dental plan or to explore other Discount Networks provided through Gallagher Koster Insurance Agency that complement the Premier Plan.

OTHER ANSWERS:

Q. I've reviewed the materials on the website, but still have questions, who should I contact?

A. If you can't find the answer to your question on this website, refer to the contact page inside the front cover of the Description of Benefits Booklet for information on who to contact with your specific concern. Student Health Insurance is also available to direct you to the appropriate contact with answers to your questions.

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