Student Health Insurance Plan

Health insurance overview

2018-2019 Student Health Insurance Plan (Pacific Source)

Effective 8/1/18 for Summer B (August starts) NEW students and 9/22/18 for all returning and NEW (September starts) students.

OHSU requires all eligible students to carry major group health insurance. For the 18/19 academic year OHSU has partnered again with PacificSource Health Plans to offer its University Sponsored Health Insurance Plan.

Eligible students are automatically enrolled.

Dependent coverage is not offered on the Student Health Insurance Plan.

For students with other major group health coverage, an insurance waiver application will be available approximately one month prior to the term start date and must be completed before the due date each year. Please note, there are separate waivers for medical and dental.

View current brochures and plan information at PacificSource

Need a temporary ID card, your member ID, or information about your benefits? Contact PacificSource at 855-274-9814 (toll-free) or via email

Eligibility, enrollment dates and/or general questions? Call USI, our health insurance broker, at 800-853-5899 or email  them with your questions. You can also visit USI's website.

Questions about anything else related to the Student Health Insurance Plan? The OHSU Human Resources Benefits Office is now the main contact for all questions related to the Student Health Insurance Plan.  You are welcome to contact them via email or phone at 503-494-7617, option 4, if you have any questions about the waiver application process, plan costs, coverage information, help with claims and billing, assistance contacting USI or PacificSource, and anything else that comes up regarding the Student Health Insurance Plan.

Medical insurance

OHSU requires all eligible students to carry comparable medical health insurance.  All eligible students will be automatically enrolled in the Student Health Insurance Plan and have the Student Health Insurance Plan premium billed to their student account unless they have other comparable coverage AND complete and are approved for a health insurance waiver by the deadline.  Please note that a separate waiver is required if you wish to waive out of dental insurance as well.

For the 2018-2019 academic year, OHSU has partnered with PacificSource to offer its University Sponsored Student Health Insurance Plan.

2018-2019 academic year

Spring and Summer terms: 4/2/19 – 9/21/19

  • Medical rates (includes vision): $1,446.29
  • Dental rates: $111.12

Spring term only: 4/2/19 – 6/30/19

  • Medical rates (includes vision): $1,063.69
  • Dental rates: $81.29

Summer term A: 6/15/19 – 9/21/19

  • Medical rates (includes vision): $1,180.74
  • Dental rates: $90.42

All current brochures and plan detail information are available at PacificSource.

Loss of other coverage

Eligible students who involuntarily lose coverage under another group insurance plan are also eligible to purchase the OHSU Student Health Insurance Plan. These students must provide USI with proof that they have lost insurance through another group (certificate and letter of ineligibility) within 30 days of the qualifying event. Students can contact USI at (800) 853-5899, Monday through Friday, 8 a.m. to 5 p.m. The effective date would be the later of: (a) term effective date, or (b) the day after prior coverage ends if enrollment request is received within 31 days from loss of prior coverage. Payment for that term's coverage would be provided directly to USI.

Leave of absence, university approved

If leave is declared after the 100 percent refund deadline, the student will remain covered through the rest of the term coverage period and can elect one additional term of coverage (per academic career) if the LOA is an approved medical leave. Enrollment and payment for this one term of medical leave coverage will be done directly through USI.

If leave is declared prior to the 100 percent refund deadline, the student will not be covered for the term unless it is an OHSU approved medical leave. For those on an OHSU approved medical leave, they will have the option to enroll in the student health insurance plan for the current term only. Enrollment and payment for the remainder of this term's coverage period will be done directly through USI. The student will not be able to elect an additional term of coverage.

Previous enrollment in the prior term is required in order to qualify for a term of coverage for medical leave. A maximum of one term of medical leave health insurance coverage will be granted during your academic career.

Students who qualify for medical leave of absence coverage must enroll within 31 days from their leave date.

Late admit

Students who register after the 100 percent refund deadline will be enrolled in the whole term coverage period with back-dated coverage from the start of this period. If they wish to waive out of the SHIP, they will need to contact the JBT office upon registration for an alternative process.

Graduation

Students’ coverage with PacificSource will terminate at the end of the term coverage period. PacificSource does not offer any type of continuation plan. Students whose coverage comes to an end are eligible for a special enrollment period through the federal healthcare exchange due to the loss of coverage. Students can find out more information by visiting the website.

Dependent coverage is not offered through the Student Health Insurance Plan.

Dental insurance

OHSU requires all eligible students to carry comparable dental insurance. All eligible students will be automatically enrolled in the Student Dental Insurance Plan and have the Student Dental Insurance Plan premium billed to their student account unless they have other comparable coverage and complete and are approved for a dental insurance waiver by the waiver deadline.

Note that this is a separate form from the medical insurance waiver.

For the 2018-2019 academic year, OHSU has partnered with PacificSource to offer its University Sponsored Dental Insurance Plan.

2018-2019 academic year

Spring and Summer terms: 4/2/19 – 9/21/19

  • Medical rates (includes vision): $1,446.29
  • Dental rates: $111.12

Spring term only: 4/2/19 – 6/30/19

  • Medical rates (includes vision): $1,063.69
  • Dental rates: $81.29

Summer term A: 6/15/19 – 9/21/19

  • Medical rates (includes vision): $1,180.74
  • Dental rates: $90.42

All current brochures and plan detail information are available at PacificSource.

Loss of other coverage

Eligible students who involuntarily lose coverage under another group insurance plan are also eligible to purchase the OHSU Student Health Insurance Plan. These students must provide USI with proof that they have lost insurance through another group (certificate and letter of ineligibility) within 30 days of the qualifying event. Students can contact USI at (800) 853-5899, Monday-Friday, 8:00 a.m. - 5:00 p.m. The effective date would be the later of: (a) term effective date, or (b) the day after prior coverage ends if enrollment request is received within 31 days from loss of prior coverage. Payment for that term's coverage would be provided directly to USI.

Leave of absence, university approved

If leave is declared after the 100% refund deadline, the student will remain covered through the rest of the term coverage period and can elect one additional term of coverage (per academic career) if the LOA is an approved medical leave. Enrollment and payment for this one term of medical leave coverage will be done directly through USI.

If leave is declared prior to the 100% refund deadline, the student will not be covered for the term unless it is an OHSU approved medical leave. For those on an OHSU approved medical leave, they will have the option to enroll in the student health insurance plan for the current term only. Enrollment and payment for the remainder of this term's coverage period will be done directly through USI. The student will not be able to elect an additional term of coverage.

Previous enrollment in the prior term is required in order to qualify for a term of coverage for medical leave. A maximum of one term of medical leave health insurance coverage will be granted during your academic career.

Students who qualify for medical leave of absence coverage must enroll within 31 days from their leave date.

Late admit

Students who register after the 100% refund deadline will be enrolled in the whole term coverage period with back-dated coverage from the start of this period. If they wish to waive out of the Student Dental Insurance Plan, they will need to contact the JBT office upon registration for an alternative process.

Graduation

Students’ coverage with PacificSource will terminate at the end of the term coverage period. PacificSource does not offer any type of continuation plan. Students whose coverage comes to an end are eligible for a special enrollment period through the federal healthcare exchange due to the loss of coverage. Students can find out more information by visiting the website.

Dependent coverage is not offered through the Student Health Insurance Plan.

Waivers

The 2018–2019 waiver process is managed by our insurance broker, USI.

The waiver process is available online only.

Only students who are registered for the current term will be able to submit a waiver.

There are separate online waivers for medical and dental. If you wish to waive both the student medical and dental insurance, you will need to complete two separate online waiver applications.

An automatic pass/fail will be issued after submitting the online waiver.

Approved waivers will be good through 9/21/2019.  Students must submit new waivers each year if they continue to have comparable coverage and wish to waive out of the student plans.

If the waiver deadline is missed, the student will have to wait until the following term waiver period to apply.

USI Support Team can be reached toll free at 800-853-5899 or via their direct email.

Please review this policy regarding the procedure that OHSU will follow if a student is found to be uninsured.

Questions about the medical and/or dental waiver?

If you have any questions about the waiver application process, waiver appeal process, or the student health or dental plan, please contact the OHSU Human Resources Benefits Office.

studentinsurance@ohsu.edu

503-494-7617, option 4

2018-2019 academic year

Spring and Summer terms: 4/2/19 – 9/21/19

  • Online waiver begins: 3/2/19
  • Online waiver closes: 4/13/19
  • Medical rates (includes vision): $1,446.29
  • Dental rates: $111.12

Spring term only: 4/2/19 – 6/30/19

  • N/A: no online waiver
  • Medical rates (includes vision): $1,063.69
  • Dental rates: $81.29

Summer term A: 6/15/19 – 9/21/19

  • Online waiver begins: 5/25/19
  • Online waiver closes: 7/6/19
  • Medical rates (includes vision): $1,180.74
  • Dental rates: $90.42

Domestic students have a waiver application that requires an attestation similar to the draft form below. International students have a waiver application that has additional required elements.

Please note, there are two waivers: one for medical and one for dental. The below criteria are for the medical waiver. To waive dental, the only requirement is to be able to demonstrate comparable coverage.

Once your waiver is approved for 2018-2019, it will be good through September 2019 and you do not need to re-apply each term. The waiver site opens approximately a month prior to the term start date. You MUST be registered in order to be able to waive. Once registered, please give the system 48-72 hours to update your eligibility.

Your comparable plan must be effective on or before the start of the insurance term.

  • Summer B - 8/1/18
  • Fall - 9/22/18
  • Winter -1/7/19
  • Spring - 4/1/19
  • Summer A - 6/15/19

If you already have a health insurance plan that you feel is comparable to the Student Health Insurance Plan and wish to apply for a waiver from the student plan, please be prepared to attest to the waiver requirements below.

If you do not have the answers to the questions listed below, please contact your insurance company to collect all the information prior to applying.

It is important to note that the Student Health Insurance Plan offers worldwide coverage, while many seemingly comparable health insurance plans through the federal exchange or the Medicaid system (Oregon Health Plan) may only have limited coverage and/or networks if leaving your local area which could result in limited or no benefit coverage.

Domestic Medical Plan Waiver Criteria

  • The plan is effective on or before the start of the term.
  • The plan has in-patient hospital coverage at a minimum of 80%.
  • The plan has prescription drug coverage.
  • The plan has a deductible of $2,500 or less.
  • The plan has an annual plan maximum.
  • The plan has in-patient and out-patient mental health benefits.
  • The plan provides care in the state of Oregon.
  • Plan meets Silver, Gold or Platinum coverage value per the Affordable Care Act

Dental Plan Waiver Criteria

  • Coverage for diagnostic services (e.g., examinations and x-rays)
  • Coverage for preventive services (e.g., topical fluoride and periodontal maintenance)
  • Coverage for restorative services (e.g., fillings and crowns)

International Medical Plan Waiver Criteria

  • Coverage is in effect the first day of the term
  • Plan provides both local and national coverage
  • Plan provides inpatient and outpatient mental health benefits
  • Plan provides a minimum of 80% coverage for inpatient hospitalizations
  • Plan provides coverage for medical evacuation and repatriation
  • Plan does not have pre-existing condition exclusions
  • Plan does not have coverage minimums or maximums (i.e., maximum benefit payment per incident)
  • Plan includes pharmacy benefits (not a pharmacy discount program)
  • Plan meets Silver, Gold or Platinum coverage value per the Affordable Care Act

Any student who submits a waiver and is denied has the option to appeal. Our insurance broker, USI, handles all waiver appeals. If your waiver is denied, you will be provided the steps of how to submit your online waiver appeal. All waiver determinations will be based upon the waiver criteria that has been set by the OHSU Student Health Advisory Committee and no exceptions will be made.

For inquiries about a waiver appeal or the status please call USI at 866-769-7600 or email them directly at studentinsuranceservices@usi.com.

Students who are approved for a waiver and then experience a qualifying life event — e.g., age off a parental plan, loss of spousal insurance, cancellation of policy, etc. — are eligible to enroll in the Student Health and Dental Insurance Plan.

Please notify OHSU Human Resources within 31 days of the event. Please contact them at studentinsurance@ohsu.edu or by calling 503-494-7617, option 4.

Enrollment would be for the full term period and coverage would begin the date coverage was lost.

Postdoctoral scholars insurance

Eligible postdoctoral scholars can receive employee benefits at OHSU, including medical, dental, and vision.  Please visit the Office of Postdoctoral Affairs website for the most up-to-date information.

Regardless of insurance, postdocs are eligible for services at JBT Health & Wellness Center.  Please visit other pages on our site for more information on JBT's services, including primary care, behavioral health, integrative medicine, and wellness.

Who do I contact if I have questions?

  • For questions about health-related appointments at JBT, including medical, counseling, or psychiatric appointments, call JBT at 503-494-8665 or email askjbthealth@ohsu.edu
  • For questions about postdoc insurance, including enrollment, waivers, changes in coverage, qualifying events, etc., email the postdoc liaison
  • For questions about insurance benefits (medical, dental, or vision), claims, ID cards, or pre-certification, visit the O2 Employee Benefits page.