90.24 - Student Health Insurance Requirement
- Position: Student Insurance Office Director
- Email: firstname.lastname@example.org
Last updated: September 08, 2023
A. Purpose. The purpose of this policy is to ensure the health and wellness of students by setting forth requirements for student health insurance.
B. Scope. This policy applies to all students at the University of Idaho.
C-1. In general. At the University of Idaho, preserving our student’s health and wellness is paramount. Access to health services and payments for healthcare services can hinder a student from achieving their academic goals. This policy was founded on removing as many obstacles as possible for our students to reach graduation.
C-2. Health insurance required. All domestic full-time degree-seeking undergraduate students enrolled in 12 or more credits, graduate and law students enrolled in 9 or more credits, student athletes enrolled in 1 or more credits and all international students with sponsored government health insurance as part of their educational program are required to show proof of personal health insurance before they can complete enrollment of academic classes each semester. In each semester, if proof of personal health insurance is not provided, the student will be enrolled automatically into the Student Health Insurance Program (SHIP) and will be responsible for the associated charges.
C-3. Coverage requirements for all non-SHIP policies. All personal health insurance policies for both domestic and international students must adhere to the Affordable Care Act. In order to opt out of the Student Health Insurance Program (SHIP), a student must provide proof of a health insurance policy that meets the following requirements:
a. The plan does not have any limitations or exclusions on pre-existing conditions.
b. The plan covers hospital stays for medical and surgical care and inpatient care for mental health conditions.
c. The plan covers doctors’ office visits for medical care and outpatient care for mental health conditions.
d. The plan covers prescriptions written by a doctor. Prescription benefits through a third-party vendor such as CVS Caremark, etc. are acceptable.
e. The plan provides access to a provider network within the Moscow/Pullman area. Coverage must be available for routine, diagnostic, urgent and hospital care. Coverage for only telehealth, urgent and emergency care is not acceptable.
f. The plan covers services related to injury from participation in all types of recreational sports, including intercollegiate athletics.
g. If the plan has a deductible, either 1) the deductible is less than $1500 or 2) the student provides proof of financial means to meet the higher deductible amount. A funded FSA or HSA account may be used to meet this requirement.
h. The plan covers maternity care, including prenatal care and delivery, with no pre-existing condition limitations.
i. The plan provides coverage for diagnostic services, including laboratory tests.
j. The plan pays 70% or more of usual, customary, reasonable charges per accident or illness, after deductible is met, for in-network providers, and 50% or more of usual, customary, reasonable charges for out-of-network providers per accident or illness.
C-4. Medical evacuation and repatriation coverage for students in J visa status. The University provides the medical evacuation and repatriation coverage required by the Department of State for international students in J visa status.
C-5. Policies not accepted. Travel plans, county medical service plans (i.e., Medicaid) outside the state of Idaho or Washington, fixed indemnity plans, short-term plans, and supplemental or reimbursement plans are not accepted as comparable coverage.
C-6. Effective dates of coverage. All plans must meet the following requirements:
a. The plan is effective on or before the first day of the semester with no break in coverage.
b. The plan is effective on the first day of the calendar month following the first day of the semester.
c. The plan is effective on or before the first day of the calendar month following an involuntary loss of previous coverage.
d. The plan does not have a gap in coverage of more than seven days. If the plan has a gap in coverage longer than seven days, the student must provide proof of COBRA coverage.
C-7. Audit. To ensure legal compliance, information provided by students is forwarded to a third-party auditor each semester for verification. Students who are discovered to be uninsured or to have insurance that does not meet the minimum requirements will be enrolled in the Student Health Insurance Program and the charge will be placed on the student’s account.
D. Procedure. For SHIP program procedure, including enrollment, appeals, and policy coverage, please see the Student Health Insurance Program website.