2023-2024 Northeastern University Student Health Insurance Plan (SHIP) FAQ PDF

School Logo Here 0 © 2023 Arthur J. Gallagher & Co. Table of Contents Getting Started....................................................................................................................................................

School Logo Here 0 © 2023 Arthur J. Gallagher & Co. Table of Contents Getting Started.............................................................................................................................................................. 2 Where can I learn about the student health plan?...................................................................................................... 2 Enrolling and Waiving NUSHP..................................................................................................................................... 2 Am I eligible for student health insurance?................................................................................................................. 2 How do I waive (opt out) of NUSHP?......................................................................................................................... 2 Am I eligible to waive?................................................................................................................................................ 3 What is considered “Comparable Coverage?”............................................................................................................ 3 Will you audit or verify my waiver request?................................................................................................................ 4 Can I cancel my waiver form after I’ve submitted it?.................................................................................................. 4 Can I enroll my dependents?...................................................................................................................................... 4 About My Benefits......................................................................................................................................................... 5 How can I get more information about my plan?........................................................................................................ 5 Fenway Health............................................................................................................................................................ 5 Telehealth Services.................................................................................................................................................... 6 Mental Health Services............................................................................................................................................... 6 Travel Services........................................................................................................................................................... 7 How do I obtain an ID card?....................................................................................................................................... 7 How do I obtain a Verification of Coverage Letter?.................................................................................................... 7 How do I obtain a Tax Form?..................................................................................................................................... 8 How do I change my address?................................................................................................................................... 8 Who do I contact?....................................................................................................................................................... 9 1 Getting Started Where can I learn about the student health plan? Information about the Northeastern Student Health Plan can be found at here. Enrolling and Waiving NUSHP Am I eligible for student health insurance? Northeastern University’s student health plan (NUSHP) is administered by Blue Cross Blue Shield of Massachusetts and provides comprehensive health benefits at an affordable rate. Self-funded student health plans, such as the NUSHP, are not subject to regulation under the Patient Protection and Affordable Care Act (ACA). NUSHP is voluntarily including in its program benefits that are designed to meet or exceed requirements that would otherwise apply to fully insured student health insurance programs. Every full-time and part-time student enrolled in a certificate, diploma or degree granting program in a Massachusetts institution of higher learning to participate in a Student Health Plan or in a health benefit plan with comparable coverage. The Student Health Plan defines a full-time student as having full-time student status and enrolled in any amount of credits of a full-time curriculum. The Student Health Plan defines a part-time student as having part-time student status and enrolled in at least 75% of the credits required for a full-time curriculum. For CPS undergraduate students this is 9 credits, for graduate and CPS graduate students this is 6 credits. Students on co-op or on study abroad are considered active students and will be enrolled in and billed for NUSHP each academic year. Students enrolled in online programs and pre-matriculation programs are not eligible for NUSHP. Eligible students will be automatically enrolled in and billed for NUSHP once they register for classes as a full-time or part-time student and meet the minimum qualifications. How do I waive (opt out) of NUSHP? If you have comparable, domestic health coverage, you may choose to waive NUSHP by completing the waiver, found here. Parents do not have access to this waiver. Please follow the steps below to waive the insurance. Please see below for more information. 1. Log onto me.Northeastern.edu 2. Click “Resources” at the top of the page. 3. Go to “Health & Wellness” 4. Click “Health Plan Fee Waiver (NUSHP)” 2  a. This will bring you to the Gallagher website, please log in with your NU credentials. 5. Scroll down to “Plan Summary” and click on the yellow “Waive” button. 6. Enter information for your plan and click “Submit”. This waiver is to be filled out every new academic year by all eligible Northeastern students if they would not like to be enrolled in NUSHP. Students will receive an email from Gallagher Student Health letting them know when the waiver has been approved or denied. Gallagher will also send an email if more information is needed to verify coverage. If the waiver is denied, the reason will be stated in the email with information on how to appeal the judgment. Am I eligible to waive? In order to waive, you must be enrolled in a plan that is fully compliant with the Affordable Care Act and meets Massachusetts State requirements. Short term medical plans and travel insurance plans are not comparable and CANNOT be used to waive NUSHP. You must have access to providers near campus and coverage for services beyond urgent and emergency services. Therefore, if you are enrolled in an out-of-state HMO, your coverage will likely be limited — or unavailable — outside of your HMO’s service area and will not meet your school's waiver requirements. If a claim is submitted before you have an approved waiver, you must stay enrolled in the plan. Before deciding whether or not to waive coverage, compare your current health insurance plan to NUSHP to look at your possible out-of-pocket costs – deductibles, copays, coinsurance, and out-of-pocket maximums. You may find your out-of-pocket costs are greater than paying the premium for NUSHP. What is considered “Comparable Coverage?” Your health insurance plan must be fully compliant with the Affordable Care Act (ACA) and meet Massachusetts State requirements. This means your plan needs to have participating providers and cover a range of services in and around the area where you attend school. Services include, but are not limited to, preventive and non-urgent care, emergency care, surgical care, inpatient and outpatient hospitalization, lab work, diagnostic x-rays, physical therapy and chiropractic care, prescription drugs, mental health and substance abuse treatment. If your current plan is an HMO, it is very likely that coverage is limited, or not available, outside of the HMO’s service area. Before waiving coverage, you should review your current policy, and considering the following:  Is your plan fully compliant with the Affordable Care Act? (reference the “What is considered Comparable Coverage” question above)  Will your current plan cover medical care beyond emergency services (i.e. doctor’s office visits, diagnostic testing, x rays, prescription drugs, mental health, etc.) on- and off-campus? 3   If you plan to travel elsewhere during the course of the year, does your coverage extend to these areas as well?  Check the cost — is the annual cost of NUSHP less expensive than the cost of being added as a dependent to your parents’ plan? Be sure to compare deductibles and total out-of-pocket costs, not just the annual premium.  Are there administrative pre-requirements, pre-certification, or Primary Care Physician referrals required under your current plan that may delay receipt of care? Will you audit or verify my waiver request? Yes, all submitted waiver forms will be subject to waiver verification. The intent of the waiver verification process is to assess whether or not your insurance plan provides coverage that meets legal standards while students are at school. The verification process checks the insurance company information you entered on your form and confirms the information submitted is accurate and that your coverage is currently active and ACA compliant or otherwise comparable. Most waivers will be verified within 24-48 hours. Once your waiver has been verified, an email notification will be sent to your university email address. If your waiver is denied, the email will explain the reason for the denial and provide instructions on how to revise and resubmit your form and with any requested applicable supporting documentation. Can I cancel my waiver form after I’ve submitted it? Yes, but only if it's before your waiver deadline. 1. Go here 2. Follow the login instructions. 3. Navigate to “Account Details.” 4. Click “Click Here to Rescind Your Waiver.” 5. Click “Rescind My Waiver.” Note: Once waiver is rescinded, this action cannot be reversed. Can I enroll my dependents? Yes, please follow the below steps: 1. Go to the NUSHP website 2. Click Forms 3. Click ‘Petition to Add Dependents’ 4  4. Follow the instructions to complete the form 5. Email to [email protected] 6. Print or save a copy of the confirmation page 7. You will receive notification once your form has been approved or denied Once approved, the fee for enrolled dependents will be added to the student’s account. About My Benefits How can I get more information about my plan? Please visit the Benefits section of the NUSHP website. Fenway Health Introducing Fenway Health Fenway Health’s 100,000 square foot facility, just a short distance from campus, is located at 1340 Boylston Street (near Fenway Park). All of the services listed below are provided at this location. NUSHP has negotiated a reduced co-payment schedule for medical services, preventive dental care services, and vision exams. There is a 50 percent reduction in the required copayments for prescription drug copayments for NUSHP members who are established patients for Fenway Health. NUSHP members have access to these reduced prescription drug copayments if they first have a medical office visit, behavioral health visit, receive vision or dental care services, or receive a complementary care service (e.g., massage, chiropractic, or acupuncture). Prescription medications may also be delivered for pick-up at University Health and Counseling Services or private residences (other than Northeastern University’s residence halls/housing) in the Boston area for established patients. 5  NUSHP Member Copayments at NUSHP Member Copayments at Fenway Health Other Participating Blue Cross and BlueShield of Massachusetts Provider Medical Office Visit $20 $25 Routine GYN exam (one per year) $20 $25 Behavioral Health Care $20 $25 Vision Care Exam $20 Not Covered Contact Lens Fitting $40 Not Covered Preventive Dental Care Services $25 Not Covered (including X-rays) – 2 per plan year *Only for NUSHP members who are established patients of Fenway Health For more information about the services available at Fenway Health, please visit their website. To schedule an appointment, please call 617-267-0900. Telehealth Services Students who are enrolled in NUSHP and currently located within the U.S. can access telehealth visits through Well Connection. Students with NUSHP can seek medical or mental health support through the Well Connection app. There is currently no copay for Well Connection visits. Well Connection can be accessed through the MyBlue App. To learn more about Well Connection, visit BCBS’s site here. To learn more about the MyBlue App please look at our enrollment page. Mental Health Services NUSHP and Blue Cross Blue Shield (BCBS) understand that mental health care is health care. BCBS provides their members plenty of options to make the right choice for them. To learn more about what BCBS offers please check out their Mental Health Resource Center or check out their website. 6 Northeastern University also provides students with resources related to Mental Health. UHCS has expert behavioral professionals that students can work with via phone, video and in person by appointment for students in Massachusetts. Students outside of Massachusetts can access Find@Northeastern 24/7 for mental health support. To learn more information about this service please look here. You can find more information about UHCS and their mental health service check out their website. Travel Services Blue Cross Blue Shield Global (GeoBlue) offers medical evacuation and repatriation through GeoBlue. GeoBlue creates a simplified international healthcare experience for our members. Our network brings flexible coverage to every community in the U.S. and over 190 countries around the world, making it the broadest global network available. To learn more about what is included please check out our GeoBlue document here. If you have further questions, please feel free to call them on their toll-free number: 1-844-268-2686. How do I obtain an ID card? Blue Cross Blue Shield will not automatically send out physical insurance cards. Students will need to download the MyBlue app or request a physical copy from Blue Cross Blue Shield. The Verification of Coverage letter provides students with the information needed to create a MyBlue account. Once a student has created an account, they will have access to their insurance card and plan information at all times through your phone. Download the MyBlue Member App on the Apple, Google Play stores, or sign up online here. Click “Register Now” and complete the required steps. Please click here for more information on the MyBlue- Member App and be sure to download and activate your app today. If you have other questions, please check out their frequently asked questions page here. If you prefer a physical card, please reach out to Blue Cross Blue Shield or visit the Gallagher Student Health website to request one. Please confirm that your address is correct before requesting a card. If it is not, please update your local address on the Student Hub, which will update your BCBS information in 7-10 days. All cards are sent to your local address you have on file. How do I obtain a Verification of Coverage Letter? Verification Letters are usually available 5-7 business days after the request is received and your eligibility is confirmed. 1. Log into your Student Hub at me.northeastern.edu. 2. Navigate to Resources/Health & Wellness and look for the Health Plan Fee Waiver. Click this link and it will direct you to the Gallagher website. 3. Under “Profile” click “Sign Up” 7  4. Scroll down to “Account Details” 5. Click on “Verification of Coverage” **Please note that your full member ID number includes the prefix “NUQ” How do I obtain a Tax Form? If the federal government requires reporting of health insurance coverage for 2022 or 2023, tax forms will be mailed to the address on file by either the Insurance Carrier or the Claims Administrator. Please refer to the Important Contact Information Section of this document for further information. How do I change my address? Students must update their local address information on their Student Hub. This update will be sent to Gallagher Student Health and Blue Cross Blue Shield. 1. Go to the Student Hub at me.northeastern.edu 2. Sign in with your Northeastern credentials 3. Select Resources on the top left of the screen 4. Select Miscellaneous, the last option on the Resources menu on the far right 5. “Current Address Form” is the second option that will appear under Miscellaneous Please wait 7-10 days for the updated address to be reflected on BCBS. 8 Contact Information Who do I contact? See the guide below: Answer Needed Who To Contact Contact Information 500 Victory Road Quincy, MA 02171 Enrollment, Coverage or Service Gallagher Student Health & Special www.go.gallagherstudent.com/northeastern Concerns Risk click “Help Center” Address: 101 Huntington Avenue, Suite 1300 ID Cards, Benefits, Claims, Claims Blue Cross Blue Shield of Boston, MA 02199-7611 Payments Incurred and Tax Forms Massachusetts Phone: 1-888-648-0825 Website: http://www.studentbluema.com/home.php Blue Cross Blue Shield of www.go.gallagherstudent.com/northeastern Preferred Provider Network Massachusetts click “Find a Doctor” Address: Northeastern University 135 Forsyth Building 360 Huntington Avenue Additional Health Plan Questions NUSHP Office Boston, MA 02115 Phone:1-617-373-8007 Email: [email protected] 9