Mandatory Health Insurance for all Emory Students
Effective Fall Semester 2006

When uninsured/underinsured students become seriously ill or injured, their academic careers can be significantly threatened by substantial healthcare debt, disability or both.   Therefore, effective Fall Semester 2006, all new and continuing degree-seeking and international Emory University students (including Oxford College ) will be required to have health insurance.   Under this requirement, students must either purchase the Emory University Student Health Insurance Plan (offered by Aetna/The Chickering Group) or provide documentation of enrollment in a comparable United States-domiciled plan.   Each Fall Semester, new and continuing degree-seeking students and all international students will have a “To Do” on their OPUS Account from mid-April, requiring them to complete the waiver process on-line by July 1st.

 
New students entering in Spring or Summer Semesters will complete the on line enrollment/waiver process prior to the start of classes (for example, for Spring 2007, the enrollment/waiver process begins October 18th and ends November 27, 2006 at 5:00 pm).  These mid-year admits will join all continuing students in completing the process for the next Fall between mid-April and July 1st. 

   
If a new or continuing Fall Semester student has not waived out of the Emory Student Health Insurance Plan by the deadline date by July 1st, he/she will be automatically enrolled in the Emory/Aetna plan and billed by the Emory Student Financial Services (SFS, also called the Bursar's Office).

Students will need to complete the annual insurance enrollment/waiver process each year they are enrolled at Emory.

To complete the insurance enrollment/waiver process for 2006-07, do the following: Click here for link to 2006/2007 enroll/waive site   If the above link does not function in your web browser, you may instead do the following: Go to www.chickering.com and select "Find Your School" Enter "Emory University" Select "Enroll/Waive" Select "Online Enrollment/Waiver System"

 

In order for an insurance plan to meet the Emory University mandatory insurance waiver criteria, the insurance plan must feature, at a minimum, all three of the following:

1. Coverage that allows the insured student to receive outpatient, emergency, specialist and inpatient care, diagnostic testing and procedures, and mental health inpatient and outpatient care, including alcohol and substance abuse treatment, in Atlanta, GA .
2. A deductible not greater than $1,050 per policy year.   If the annual deductible exceeds $1,050, the insured student must have an approved Healthcare Savings Account (HSA) that will allow the student to seek needed medical and mental health care when recommended by a healthcare provider and will cover all deductible expenses over $1,050
3. The insurance must be provided by an insurance company domiciled in the United States .
   

Please be aware the Emory/Aetna Student Health Insurance Plan meets, and in most cases significantly exceeds, these required coverage minimums.   In addition, the Emory/Aetna plan has no pre-existing condition limitations or exclusions. To read the 2006-07 plan brochure, go www.chickering.com , click on Student Connection, choose Find Your School and enter Emory University.   You will need Adobe Acrobat Reader to view the brochure.  

Emory students will submit their insurance compliance information either by linking through OPUS or via the Emory University Student Health Services (EUSHS) web site at the above noted link.

Frequently Asked Questions About the Emory University

  Mandatory Health Insurance Requirement

Questions about Emory's reasoning behind the mandatory health insurance requirement:

“I've been here two years and we never had this requirement before.   Why now?”

Emory University has always strongly encouraged students to carry medical insurance.   However, for several years we have been deeply concerned about our uninsured Emory students.   When uninsured/underinsured students become seriously ill or injured, their academic careers are seriously threatened by substantial healthcare debt, disability or both.   The University agrees, and now all Emory students across the university are required to have health insurance.  

“Why is Emory doing this when other universities are not?”

Well, actually, Emory was the only university in the 2005 US News and World Report America 's Best Colleges Top 20 without a mandatory health insurance requirement for all students.   In addition, the American College Health Association recommends that all colleges and universities require students to provide evidence that they have appropriate health insurance coverage.   As a result, there has been a very strong national movement towards mandatory health insurance for all students over the past 5 years.

“Why do Emory students need health insurance, when we can be seen for free at Student Health Services?”

Yes, visits to Student Health Services are free, but thinking that this is enough is a common and dangerous misconception.   While Emory Student Health Services provides excellent out-patient care for enrolled Emory students, EUSHS provides only out-patient primary care, short-term (but not long-term) counseling and psychiatry services.   If and when Emory students need specialist care, emergency services or hospitalization, the bills can run quickly into the tens of thousands of dollars.   Such unexpected expenses can derail, or even end, a promising academic career.

Questions about the quality and cost of the Emory/Aetna Student Health Insurance Plan and Scope of Coverage:

“Is the Emory student insurance plan any good?”  

We won't lie to you.   There was a time several years ago when many students were dissatisfied with the coverage under the Emory-sponsored student health insurance plan.   However, significant improvements have been made in the plan over the past four years.   We now feel strongly that our student health insurance plan is among the best student plans in the nation.   The 2006-07 Emory/Aetna plan will feature the following:

• A national preferred provider network of over 610,000 providers and over 3,700 hospitals, which includes all Emory outpatient and hospital facilities.   
•   Students do not have to personally complete and submit claim forms for care received.   The provider submits bills directly to Aetna .
•   There are no pre-existing condition exclusions under the Emory/Aetna student plan and no waiting period for coverage to begin. 
• The plan covers 100% of covered medical expenses at Emory Student Health Services, including the on-site EUSHS Dermatology and Gynecology/ Colposcopy clinics (after specialist $25 co-payment), immunizations, TB skin tests and Travel Clinic .  
• The plan covers 80% of negotiated charges outside Emory University Student Health Services (EUSHS) and within the Aetna network (which, once again, includes all Emory facilities).   There is a $100 total annual deductible in-network and a $25 co-pay for physician visits outside EUSHS.   Outside the Aetna network, coverage is 60% with a $200 annual deductible.
• All non-emergency specialist care must first have a written referral from the Student Health Service, unless you are more than 50 miles away from Emory or the EUSHS is closed.  
• The plan offers outpatient prescription pharmacy coverage up to $1,500 (after co-pays) and $500 of coverage at EUSHS (which includes oral contraceptives).
• Mental health outpatient and inpatient coverage has no cap on coverage, including treatment for alcohol and substance abuse.
• Coverage is also available for student's spouse, qualified domestic partner and children.

We strongly encourage you to read the plan brochure before you draw conclusions about the quality of coverage.

“What are the annual premium rates of the 2006-07 Emory/Aetna plan?”  

The premium rates for the annual 2006-07 plan are:

  “Why is this student insurance plan so expensive?    My spouse/partner pays a lot less for his/her health insurance.”

While it is possible that that is true, it is unlikely if the coverage is comparable.   Many employers provide health insurance as an employee benefit, and provide a large subsidy toward the employee's premium.   That being said, if you want lower rates, get your friends to sign up!   The more students on the plan, the more widely the risk is spread, so the rates go lower.

“Aren't there cheaper insurance policies available that meet the minimum waiver criteria?”

Yes, there are.   As noted earlier, the Emory/Aetna student policy far exceeds the coverage minimums in several areas.   However, you get what you pay for, and insurance companies are in business to make money.   We implore you to read the summary of benefits (and the fine print) and compare and contrast insurance policies before you make your decision to purchase one plan over the other.   The time to determine whether your level of coverage is adequate is now, not when you are sitting in the emergency room or lying in a hospital bed.     

“Why should students who already have excellent insurance coverage via their parents' or spouse/partner's plans be forced to also pay for the Emory plan?”

They won't be.   Emory has a mandatory health insurance requirement with a “hard waiver.”   Under this approach, students must either purchase the Emory Student Health Insurance Plan or show evidence of enrollment in a comparable health insurance plan.   If the student has not waived out of the Emory plan by the deadline date (July 1 for each Fall Semester), he/she will be automatically enrolled in the Emory plan and billed via Student Financial Services.   Therefore, no student should find himself or herself in a situation where they have two insurance plans. . . unless he/she ignores deadlines.  

  “When I leave Emory, will I automatically lose my insurance coverage?”

No, not necessarily.   You will continue to be covered for the duration of your policy (for example, if you graduate in May and your policy is good through August). In fact, if you want to extend your coverage, you will be eligible for the Continuation Plan, which can cover you for up to an additional 3, 6, or 9 months. That should give you time to get settled at your new job, school or the like. Arrangements for continuation coverage must be made while your current policy is still in effect.

“I will be going abroad in the Spring Semester.   Will the Emory plan give me coverage while I am away from the United States ?”

  Yes.   The Emory/Aetna Student Plan gives coverage both in the United States and abroad.

Questions about issues of importance to International Students:

“I am an international student and I have always been required to have health insurance at Emory.   However, I never heard about this ‘United States-domiciled' insurance company requirement.   Is this new?   Can't I have insurance from my home country?”

All international students at Emory have been required to have health insurance or to purchase the Emory student plan.   However, the requirement that the insurance company be domiciled in the United States is a Fall 2005 change in the insurance requirement for international students.   Emory has found that receiving health insurance benefits from international carriers for medical care in the United States can often be incomplete and problematic.

“Are there any additional insurance requirements for International Students that do not apply to domestic students?”  

Yes.   In addition to the coverage requirements listed for all students, International Students must have insurance that meets the following additional requirements:

•  Coverage for medical evacuation and repatriation of remains to the Insured Person's place of residence in his or her home country ($10,000 for evacuation, $7,500 for repatriation)

For J-1 exchange visitors and their J-2 dependents, the U.S. Department of State regulations require that the health insurance plan must also meet one or more of the following criteria:

•  Part of a group benefits program offered to enrolled students by a designated sponsor, or

•  A health maintenance organization (HMO) that is federally qualified as determined by the Health Care Financing Administration (HFCA) of the U.S. Department of Health and Human services, or

•  A Competitive Medical Plan (CMP) as determined by the Health Care Financing Administration (HFCA) of the U.S. Department of Health and Human services, or

•  Underwritten by an insurance company having an AM Best rating of “A-“ or above, an Insurance Solvency International, LTD. (ISI) rating of “A-“ or above, a Standard and Poor's Claims-Paying Ability rating of “A-“ or above, or a Weiss research, Inc. rating of “B+” or above.

The Emory University Student Health Insurance Plan, offered by Chickering/Aetna, meets all additional insurance requirements for international students and dependants.

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Questions about enrollment in the Emory/Aetna Plan:

“Can I waive insurance for the Fall, and then sign up for the Spring or Summer when my finances are in a little better shape?”

Sorry, no.   The Emory/Aetna insurance plan is an annual plan, with annual enrollment in the Fall.   The only students eligible to enroll in the Spring or Summer are students new to Emory during that semester or students with a qualifying event (see below).   

  “What if I find out that I have a serious illness or suffer an injury after the enrollment deadline, can I sign up for the insurance plan then?”

Sorry, no again.   The Emory/Aetna insurance plan is an annual plan with no pre-existing condition exclusions.   If the insurance company let students sign up at any time during the semester, after finding out that they have a serious, expensive medical problem or injury, then the rates of coverage would go way up for everybody else covered under the plan.   That's why it is called an insurance plan, not a “wait until I need it and then sign up” plan.

“What if I lose my current insurance during the school year.   Can I sign up for the Emory insurance plan then?”

Yes, you can.   After the enrollment deadline, students who have involuntarily lost health insurance coverage through a “Qualifying Life Event” (such as (1) removal from a parent's health insurance plan after achieving a landmark birthday that disqualifies them from a parent's health insurance plan, or (2) losing private insurance through loss of employment or divorce) may apply for late enrollment in the Emory University Student Health Insurance Plan. These students must provide proof that they have lost insurance through another group (certificate and letter of ineligibility) within 30 days of the qualifying event. The premium will be the same as it would have been at the beginning of that period, but the effective date would be the later of the date the student enrolls and pays the premium or the day after prior coverage ends. Premiums are not pro-rated, and the student will be responsible for paying the full premium for the term in which they enroll.

“I would like to enroll my spouse and children in the Emory/Aetna plan.   Can I do that?”  

Yes.   Go to www.chickering.com for more information about dependent coverage.

“Can I enroll my domestic partner in the plan?”  

Yes, qualified domestic partners are eligible for enrollment in the plan.   To be considered a Domestic Partner, and eligible to be covered as a Dependent of an Insured Student under the Emory University Student Health Insurance Plan, you must meet the following criteria:

1. The Domestic Partnership must have been in existence for a period of 12 consecutive months prior to the application for coverage under this Plan.
2. The members of the Domestic Partnership are not legally married to anyone.
3. The members of the Domestic Partnership must be 18 years of age or older.
4. The members of the Domestic Partnership are not related by blood closer than would bar marriage in the State of Georgia and are mentally competent to consent to a contract.
5. The members of the Domestic Partnership are each other's sole Domestic Partner, and intend to remain so indefinitely and are responsible for their common welfare.

Students who elect to enroll their Domestic Partner are required to complete an Affidavit for Domestic Partnership, which is available at the Student Health Services Insurance Office in the 1525 Clifton Road Building.   Call 404-727-7560 if you have questions.

Questions about dates of coverage, including the continuation plan:

“What are the dates of coverage of the 2006-07 Emory/Aetna plan?”  

The Emory/Aetna student health insurance is an annual plan.   Dates of coverage are as follows:

• School of Medicine                    7/15/2006 – 7/14/2007
• International Students                 8/01/2006 – 7/31/2007
• All other students                       8/15/2006 – 8/14/2007

The only students eligible to enroll in the Spring or Summer are students new to Emory during that semester or students with a qualifying event (see above).   

“What if I want to continue coverage after I graduate or otherwise leave Emory?   Can I do so under the Emory/Aetna plan?”  

Yes.   Students can purchase a continuation plan to continue coverage for 3, 6 or 9 months after they leave Emory.   For more information about the continuation plan, go to www.chickering.com .

Questions about primary care at Student Health Services and referrals for specialist care:

“Where do I get my primary medical care under the Emory/Aetna student plan?   At Student Health Services?”  

Yes.   Emory Student Health Services is the primary care provider under the plan.   Visits to EUSHS are free for enrolled students, and the insurance plan pays 100% of covered services at EUSHS (lab tests, medical supplies, medications, immunizations, Travel Clinic, etc.).

“What if I don't have the Emory/Aetna plan?   Can I still go to Student Health Services?”  

Yes, absolutely!   Your visits are still free (covered by your tuition).

“What if I don't have the Emory/Aetna plan and I get billed for ancillary services at Student Health Services?”  

EUSHS accepts cash, checks, EmoryCard, Visa and MasterCard for ancillary services (lab, medications, etc.). Although EUSHS participates in the Emory/Aetna student insurance plan, we are non-participants (sorry!) in all other plans.   However, we will file any charges a student incurs at EUSHS with his/her primary insurance carrier.   Since we are non-participants, it is possible that the carrier may not pay for these charges.   We will also provide students with copies of all relevant paperwork they will need to resolve any payment issues with your carrier.   We will wait 90 days from the date of filing the claim to receive payment.   If the charges are unpaid at that time, we will transfer the balance to the Bursar's office for billing on the student's account. But please take note: if a student's account becomes past due, Emory may withhold transcripts, grades, registration or other University provided services or goods until all past due amounts are paid.     

“I have heard that I have to have a referral to see a specialist under the Emory/Aetna student health insurance plan.   Is that true?”  

Yes, it is.   There is a referral requirement under the plan.   Emory University Student Health Services (EUSHS) offers students comprehensive primary and specialty services coordinated by EUSHS. All covered students and covered dependents age 12 years or older in need of medical care should, except in the case of a medical emergency, first seek treatment and be evaluated at EUSHS.   You may be referred to an outside medical provider if required specialist medical care is unavailable at EUSHS.  

If you are enrolled in the Student Health Insurance Plan, a referral is necessary to receive the maximum benefit under your Student Health Insurance Plan, except in the following instances:

1. (1) Treatment of an Emergency Medical Condition; or
2. (2) When EUSHS is closed; or
3. (3) When the service is rendered at another facility during breaks or vacation periods; or
4. (4) When medical care is received by a Covered Person who is more than 50 miles from campus; or
5. (5) When medical care is received by a Covered Person who is no longer able to use the EUSHS due to a change in student status; or
6. (6) Ob/Gyn services.
7. (7) Dermatological services.  

A new referral must be obtained if continuous treatment is being received from one Policy Year to the next .   Please note that dependents under age 12 are not permitted to use EUSHS and therefore are exempt from the referral limitations and requirements.

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Questions about other optional coverage, including the dental plan and the supplemental plan:

“I am interested in getting dental coverage.   Does the Emory/Aetna plan cover dental care?”  

No, except for care for injuries to sound, natural teeth and TMJ care.   However, Aetna/The Chickering Group offers a dental plan for Emory students.   You can get more information at www.chickering.com .

“Does Emory require dental insurance for students?”                   

No, it does not.

“What if I want more coverage than an aggregate lifetime maximum of $250,000 per illness or injury?”  

If you want to increase your aggregate lifetime maximum to $1,000,000, you can purchase Supplemental Major Medical Coverage through Aetna/The Chickering Group.   Go to www.chickering.com to enroll.

  Questions about payment options under the Emory/Aetna plan, including financial aid:

“How will I be billed for the Emory/Aetna insurance plan?”  

If you are enrolled into the Emory/Aetna insurance plan, you will be billed by Emory Student Financial Services (the Bursar) via your student account.   If you have the payment plan, the cost of the insurance will be divided into your individual Fall and Spring payments.   You should see your first insurance charge with your July 2006 bill.   If you are not on the payment plan, but would like to be, contact Student Financial Services at 404-727-6095.

  “Can I get financial aid to cover the Emory/Aetna insurance plan?”  

Because health insurance is now mandatory for all Emory students, if you are eligible for financial aid, you can request access to additional loans for the amount of the premium.   Contact the Office of Student Financial Aid at 404-727-6039 or stop in at their offices at the B. Jones Center.

“Can I charge the cost the Emory/Aetna insurance plan for my spouse, domestic partner or children to my Emory Bursar account?”  

Sorry, no.   If you wish to enroll dependents in the plan, you must go to www.chickering.com .   The Emory Bursar (Student Financial Services) will only bill for student insurance, since students are required to have insurance.   Spouses, partners and children are not.

Questions about the waiver process, including appeals:

“If I waive off the insurance plan for Fall 2006, then I am good for the next four years at Emory, right?”  

No!   Every Emory degree-seeking and international student must complete the enrollment/waiver process once a year (each Fall Semester) every year.

“What if I make a mistake while I am completing the waiver, or if my insurance situation changes between the day I complete the waiver and the July 1 st deadline?”  

If you make a mistake while completing the waiver process, or if your situation changes prior to July 1st (you get insurance, you lose the insurance you had, etc.) please contact the Emory Student Health Services Insurance Office at 404-727-7560 and they will reset your on-line waiver screen.

  “Why does Emory have a requirement that the annual deductible on my plan must be $1,050 or less or I must have a certified Healthcare Savings Account (HSA)?”  

Emory has found that students avoid going to the doctor or the emergency room, refuse needed hospitalizations, or won't allow important tests, x-rays or scans to be done, if their deductible is very high ($1,500, $2,000, $5,000).   The whole point of the mandatory insurance requirement is to give Emory students insurance coverage that will allow them to get important, needed healthcare so that they can successfully complete their degrees.   This waiver criteria helps us to achieve that goal.

“What if I fail the waiver process or I miss the deadline and get charged for the Emory/Aetna insurance plan and I want to appeal the charge?   Can I do that?”  

Yes, but you will need a pretty good reason (e.g. “I was in the hospital in a coma,” “I was abducted by Martians,” etc.).   Emory will have a formal committee to review and vote on appeals.   Each Fall, the deadline for this appeals process for the annual plan will be on or about September 15th. If you have questions or concerns about the mandatory student health insurance requirement or your individual situation relative to the requirement, please contact the Student Health Services Insurance Office at 404-727-7560, 404-727-5632 or mandatoryinsurance@listserv.cc.emory.edu , or Michael Huey, MD, Executive Director, at mhuey@emory.edu or 404-712-8652. To view the Mandatory Insurance Waiver FAQs page, click here.

Questions about how to get help if you have a question or problem:

“Where do I go if I have questions about Emory's mandatory insurance requirement or the online enrollment/waiver process?”  

For answers to these questions, please contact:

Emory University Student Health Services

Insurance Office

1525 Clifton Road

Atlanta , GA 30322

404-727-7560

ktaylo2@emory.edu

“What if I want to talk to the main person in charge of all of this, the Student Health Executive Director himself?”  

To reach the Student Health Services Executive Director, please contact:

Michael Huey, MD

Executive Director

Emory University Student Health Services

1525 Clifton Road

Atlanta , GA 30322

404-712-8652

mhuey@emory.edu

“Where do I go if I have questions about enrollment, insurance benefits or claims processing?”  

For answers to these questions, go to:

Chickering Claims Administrators, Inc.

P.O. Box 15708

Boston , MA 02215-0014

(877) 261-8403

“What if I am more comfortable looking up answers to my questions and getting information on line?”  

As a Chickering/Aetna student health insurance member, you have access to Aetna Navigator ®, your secure member web site, packed with personalized benefits and health information. You can take full advantage of this interactive web site to complete a variety of self-service transactions online.   By logging on to Aetna Navigator, you can:

• Review who is covered under your plan.
• Request member ID cards.
• View Claim Explanation of Benefits (EOB) statements.
• Estimate the cost of common health care services and procedures to better plan your expenses.
• Research the price of a drug and learn if there are alternatives.
• Find health care professionals and facilities that participate in the Emory Student Insurance Plan.
• Send an e-mail to Chickering Customer Service at your convenience.
• View the latest health information and news, and more!

To register for Aetna Navigator:

• Go to www.chickering.com
• Click on “Find Your School.”
• Enter “ Emory University ” and then click on “Search.”
• Click on Aetna Navigator and then the “Access Navigator” link.
• Follow the instructions for First Time User by clicking on the “Register Now” link.
• Select a user name, password and security phrase.

If you need help with registration, assistance is available toll free, Monday through Friday, from 7 a.m. to 9 p.m. Eastern Time at 1-800-225-3375.

“What if I have questions about or problems with my Aetna insurance ID card?”  

Permanent ID cards will be issued as soon as possible after the enrollment/waiver on line site closes.   If you need medical attention before your ID card is received, benefits will be payable in accordance with the Policy.   You do not need an ID card to be eligible to receive benefits.   Once you have received your ID card, present it to the provider to facilitate payment of your claims.   You will receive a unique Aetna member ID number on your membership card.   For lost ID cards, contact Chickering Claims Administrators, Inc. at (877) 261-8403, or visit www.chickering.com , click on “Find Your School” and enter “ Emory University .”

“How do I find a list of preferred providers under my Emory/Aetna student health insurance plan?”  

A complete list of preferred providers can be found at Emory University Student Health Services (EUSHS), or you can use Aetna 's DocFind® Service located at www.chickering.com .   Click on “Find Your School” and enter “ Emory University ”. You can use DocFind to find out whether a specific provider belongs to Aetna 's network or to find Preferred Providers practicing in your area.

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© 2006-2007 Emory University, Atlanta, GA

Revised 04/02/07