Good health care is essential to your academic success! The Student Health Insurance plan is designed to work in conjunction with the Student Fee funded services provided at the CSU Health Network to ensure students have access to comprehensive high quality care. This program provides benefits both within the CSU Health Network and when services are provided outside of the CSU Health network.
2012/2013 Student Health Insurance Brochure (Includes information on plan benefits, costs, and coverage periods)
| Semester | Enrollment/Cancellation Deadline |
|---|---|
| Fall Semester | September 5, 2012 |
| Spring/Summer Semester | February 6, 2013 |
| Summer (12 Week Session) | May 20, 2013 |
| Summer (8 Week Session) | June 17, 2013 |
Under the terms required by our insurance carrier, no enrollment or cancellations may be made after the published enrollment/cancellation date outlined above. It is the responsibility of the student to view your online account statement at the beginning of each term (and prior to the enrollment/cancellation deadline) to ensure that it reflects the intended level of Student Health Insurance enrollment.
Many students and parents have questions about how insurance coverage and pricing is affected by Health Care Reform and the Patient Protection Affordable Care Act. This pdf, developed by Summit America, the Student Health Insurance plan carrier, provides a brief overview: Summary of Health Care Reform pdf.
The 2012/2013 CSU Student Health Insurance Plan provides benefits both within the CSU Health Network (Campus Advantage) and when services are provided outside of the CSU Health Network.
View a list of plan benefits.
View the Health Care Reform Required Preventive Services for Adults.
Colorado State University students, spouses, partners and dependent children up to age 26 are eligible for coverage under the plan. The following provides a summary of plan eligibility for the 2012/2013 Plan year.
2012/2013 Insurance Brochure (PDF).The following provides premium information for the 2012/2013 plan year. It should also be noted that because the plan is designed to work in conjunction with the fee-funded services provided at the CSU Health Network, all students enrolled in the plan must also pay the semester health fee. Spouses, Partners and Dependent Children enrolled on the plan who choose to access care at the Hartshorn Clinic of the CSU Health Network can do so by paying the semester health fee or by paying for services rendered on a fee for service basis.
| Schedule of Costs | |||
|---|---|---|---|
| Fall | Spring/Summer | Summer Only | |
| Student Only | $1,135 | $1,254 | $713 |
| Spouse | $2,598* | $2,925* | $1,657* |
| All Children | $1,557* | $1,750* | $992* |
| * The cost for Spouse and/or Children is in addition to the Student Only cost. | |||
All insurance premiums for students, spouses/partners and dependent children are billed directly to the student's University account and are payable in accordance with the established university e-billing procedures and billing deadlines.
Note: If you are enrolled in the CSU Student Insurance Plan, you must pay the student health fee. If you are a full-time student taking six or more credits, this fee will be included in your general fees. If you are taking fewer than six credits, this fee will be applied separately to your student account after the add/drop date.
Account Statements are provided to students via the University e-billing process. As a result, it is important that students monitor their applicable e-mail account regularly.
| Semester | Enrollment/Cancellation Deadline |
|---|---|
| Fall Semester | September 5, 2012 |
| Spring/Summer Semester | February 6, 2013 |
| Summer (12 Week Session) | May 20, 2013 |
| Summer (8 Week Session) | June 17, 2013 |
Under the terms required by our insurance carrier, no enrollment or cancellations may be made after the published enrollment/cancellation date outlined above and therefore no refunds can be made after this date. It is the responsibility of the student to view your online Colorado State University Online Account statement at the beginning of each term (and prior to the enrollment cancellation deadline) to ensure that it reflects the intended level of student insurance enrollment.
The coverage dates for the 2012/2013 plan are outlined below.
| Coverage Dates For 2012/2013 School Year | |
|---|---|
| Semester | |
| Fall | August 20, 2012 - January 21, 2013 |
| Spring/Summer | January 22, 2013 - August 25, 2013 |
| Summer Only | May 20, 2013 - August 25, 2013 June 17, 2013 - August 25, 2013 |
Specific detailed information about plan effective and termination dates and times is available in
the
2012/2013 Insurance Brochure (PDF).
Colorado State University embraces the rationale that financial risks - those that may impact a student's ability to complete his or her studies while attending the university - should be minimized. As a result, university policy requires mandatory demonstrated comparable health insurance for all full-fee paying, resident instruction Graduate Students and for all Graduate and Undergraduate International Students.
Graduate Student Enrollment
All graduate students (except graduate students with a status of continuous registration only) who are enrolled in at least one resident instruction credit hour are automatically enrolled in the CSU Student Insurance Plan each semester. Students who are enrolled in less than 6 credits may opt out of coverage by contacting the CSU Student Insurance Office (information in the Student Insurance Office tab below) before the plan enrollment/cancellation deadline. If you do not opt out of the plan before this deadline you will be billed for the premium. Graduate students with a status of continuous registration only are not automatically enrolled in the plan and must enroll in the plan by contacting the student insurance office.
Students who are enrolled in 6 or more resident instruction credit hours are subject to the graduate student mandatory insurance requirement. In order to opt out of the plan these students must demonstrate proof of comparable coverage via the University waiver process (information in the Waiver Process tab below) administered by the CSU Student Insurance Office. All waiver requests must be made no later than the plan enrollment/cancellation deadline. Students who have been granted a waiver in the fall semester will be automatically waived in the spring semester as well. Learn more about this policy on the Graduate School Website.
International Student Enrollment
International Students (both graduate and undergraduate) who are enrolled in at least one resident instruction credit hour are required to maintain health insurance and are automatically enrolled in the plan each semester. International Students may waive the insurance requirement and enrollment in the plan by demonstrating proof of comparable coverage via the University waiver process (information in the Waiver Process tab below) administered by the CSU Student Insurance Office. All waiver requests must be made no later than the plan enrollment/cancellation deadline. Students who have been granted a waiver in the fall semester will be automatically waived in the spring semester as well.
Enrollment/Cancellation Deadlines
All waiver requests must be made no later than the plan enrollment/cancellation deadline.
| Semester | Enrollment/Cancellation Deadline |
|---|---|
| Fall Semester | September 5, 2012 |
| Spring/Summer Semester | February 6, 2013 |
| Summer (12 Week Session) | May 20, 2013 |
| Summer (8 Week Session) | June 17, 2013 |
Under the terms required by our insurance carrier, no enrollment or cancellations may be made after the published enrollment/cancellation date outlined above. It is the responsibility of the student to view your online Colorado State University Online Account Statement at the beginning of each term (and prior to the enrollment/cancellation deadline) to ensure that it reflects the intended level of Student Health Insurance enrollment.
Undergraduate Students
While health insurance is not mandatory for domestic undergraduate students, it is strongly recommended. Students should verify coverage under their current health insurance plan, and bring their insurance and prescription drug cards with them to campus.
Domestic undergraduate students enrolled in 6 or more credits who would like to enroll in the CSU Student Health Insurance Plan may do so by making an on-line election to enroll in the plan during the Registration Ready Process or in person at the CSU Student Insurance Office (information in the Student Insurance Office tab below) during the open enrollment period.
Domestic undergraduates who choose to enroll in the plan must re-enroll each semester to have continuous coverage. Re-enrollment is not automatic. Domestic undergraduate students who do not wish to purchase the student insurance plan should indicate "no" when prompted about insurance enrollment during the Ready Registration Process.
Spouses, Partners and Dependents
Eligible students who enroll in the plan may also insure their spouse/domestic partner and/or Dependent Children (up to age 26) as of the date of the student's plan enrollment. This enrollment must be made in person at the CSU Student Insurance Office (information in the Student Insurance Office tab below) during the open enrollment period. Any enrollments or cancellations must be made before the enrollment/cancellation deadline. Spouses/Domestic Partners and Dependent Children must be re-enrolled on the plan each semester. Re-enrollment is not automatic.
Enrollment/Cancellation Deadlines
All enrollment and cancellations for students, spouses, partners, and dependents must be made prior to the plan enrollment/cancellation deadline.
| Semester | Enrollment/Cancellation Deadline |
|---|---|
| Fall Semester | September 5, 2012 |
| Spring/Summer Semester | February 6, 2013 |
| Summer (12 Week Session) | May 20, 2013 |
| Summer (8 Week Session) | June 17, 2013 |
Under the terms required by our insurance carrier, no enrollment or cancellations may be made after the published enrollment/cancellation dates outlined above. It is the responsibility of the student to view your online account statement at the beginning of each term (and prior to the enrollment/cancellation deadline) to ensure that it reflects the intended level of Student Health Insurance enrollment.
Colorado State University Health Network contracts with an insurance company to provide students with an insurance plan that meets the Federal Health Care Reform (HCR) law at the best possible price. Every three to five years the CSU Health Network puts the student insurance plan through a formal bid process that is administered by CSU's Purchasing Department. The last bid process was completed in the Spring 2012 for the 2012-2013 plan year.
Colorado State University's international students and graduate students are required to have health insurance which meets the requirements of CSU and is HCR compliant. This protects the students' valuable education investment and acknowledges the high cost of health care in the United States.
Federal Law regarding health insurance and minimum requirements has recently changed. CSU is in compliance with the Federal Law as it relates to Health Care Reform (HCR) for student insurance plans. Please do not ask us to violate either the Federal Regulations that govern your visa status or Federal HCR law by asking us to accept your health insurance plan that does not meet these requirements. For more information on HCR requirements and this law, as well as to review insurance plan options, please go to www.healthcare.gov.
Please be aware that most insurance products constructed exclusively for international students are not compliant with the Federal Health Care Reform Law.
Graduate and International students who are required to enroll in the Student Insurance Plan may request a waiver of the CSU mandatory insurance if they can demonstrate proof of comparable coverage under another insurance plan.
Domestic Undergraduate students are not required to show proof of insurance and do not need to go through the waiver process.
If your insurance plan was approved for the Fall 2012 semester you will not have to apply for a waiver again until Fall 2013.
Students should do the following before requesting a waiver:
Waivers may be approved for the following types of insurance plans:
Waivers will not be approved for the following types of insurance plans:
2013 Student Health Insurance Waiver Form
During the enrollment period, students may submit a waiver request package to the CSU Health Network Student Insurance Office in a variety of ways:
CSU Health Network
Student Insurance Office
Campus Delivery 8031
Fort Collins, CO 80523-8031
You will be notified by e-mail of the waiver decision no later than 10 days following receipt of a complete waiver packet.
2013 Student Health Insurance Appeal Form
In the event that a waiver request is denied and the student believes an error has been made, an appeal can be filed and the initial determination will be reviewed by the Insurance Appeals Committee. This committee is made up of members who are external to the CSU Health Network and who are knowledgeable about the University's comparable coverage requirements. Follow this link for the filing information and form: Appeal Letter and Form.
The plan is structured so that benefits are paid at a higher level if you obtain treatment or medical services from a provider in the First Health or Summit America Direct networks. You are strongly encouraged to utilize these providers whenever possible given this can reduce your out-of-pocket expenses.
Detailed information about in-network providers is available by visiting Summit America, or by calling Summit America during their business hours at (877) 296-8464.
Network providers are subject to change. Whenever possible, please contact the provider prior to obtaining medical care/treatment in order to confirm their participation in the First Health or Summit Direct networks.
If during CSU Health Network clinic hours, seek care at the CSU Health Network first (no deductible, no co-pay).
If the CSU Health Network is closed or you are out of the Fort Collins area, seek care at the nearest in-network urgent care facility (subject to plan deductible and $50 co pay)
If an urgent care facility is not available, seek care at the nearest in-network hospital emergency room (subject to plan deductible and $100 co-pay).
If an in-network provider is not available, seek care at the nearest urgent care or hospital emergency room facility (subject to plan deductible, out-of-network reimbursement rate and a $ 100 co-pay).
Dial 911 and seek care at the nearest hospital emergency room facility (subject to plan deductible, reimbursement rate based upon network status of provider and $100 co-pay which is waived if admitted.)
In-Network provider information is listed here and may be accessed 24/7. For Non-Life Threatening Emergent Care situations you can also call the CSU Health Network Referral Coordinator for assistance at (970) 491-3962 during the CSU Health network clinic hours.
For the 2012/2013 Plan Year, students do not need to submit a claim form for benefits provided at the CSU Health Network. (Also note that while a spouse/domestic partner and/or dependent children may seek treatment at the Hartshorn Clinic, they are not eligble for Campus Advantage benefits)
Campus Advantage benefits will be processed by the CSU Student Insurance Office and any ineligible expense not payable under Campus Advantage benefits or by the student health fee will be charged to the student's University account after consideration of coverage by the insurance carrier.
For the 2012/2013 Plan Year, individuals enrolled on the plan must initiate a claim form to submit medical charges for consideration of coverage under the off-campus benefits administered by Summit America.
Claims may be submitted in the following ways:
Claim information must be received as soon as possible and no later than 90 days after the date of accident or onset of illness.
Questions about benefits or claims should be directed to Summit America at (877) 296-8464.
Check back for updated information for the 2012/2013 Plan year claim filing process.
The Colorado State University Health Network Student Insurance Office provides the following services to plan participants in support of the Student Insurance Plan:
The Student Health Insurance Office is located in the basement of the Hartshorn Building just west of the Morgan Library and is staffed during university business hours.
Academic Year Hours: Monday - Friday 7:45 a.m. - 4:45 p.m., (Late opening at 9 a.m. on Tuesdays)
Summer Hours: Monday - Friday 7:30 a.m. - 4:30 p.m.
Contact information for the CSU Student Health Insurance Office
Phone:
(970) 491-5118
Due to the nature of the insurance open enrollment cycle this office experiences periods of high phone volume. If the line is busy when you call please leave a message and we will return your call as soon as possible.
Email:
CSUHN_Insurance@mail.colostate.edu
Web:
www.health.colostate.edu
Mailing Address:
CSU Health Network, Student Health Insurance Office
Colorado State University
Campus Delivery 8031
Fort Collins, CO 80523-8031
Summit America Insurance Services functions as the third party claims administrator for benefits provided under the Student Health Insurance Plan (excluding Campus Advantage Benefits). Summit America provides the following services to plan participants in support of the plan:
Contact Information for Summit America:
Phone:
(877) 296-8464 from 8:30 a.m. - 5:00 p.m. CST
Address:
7400 College Blvd. Suite 100
Overland Park, KS 66210
2012/2013 Insurance Brochure (PDF)
2012/2013 Student Health Insurance Policy
2013 Student Health Insurance Waiver Form
2013 Student Health Insurance Appeal Form
Summit America Online Claim Form
Summit America Claim Form (PDF)
This glossary is to assist you in understanding the most used terms related to the insurance industry. It can also help in understanding the student insurance program; however, all of the terms are not specific to the program offered at Colorado State and therefore the glossary should only be used as an educational reference. Please download the 2012/2013 Insurance Brochure for more detailed definitions.
Accident
An event that is sudden, unexpected, and unintended, and over ehich the Covered Person has no control.
Assigned Benefits
A statement allowing your insurance company to make (assign) payments for your medical treatment directly to the hospital or physician. Otherwise, the money will be paid to the insured when bills and claim forms are returned to the insurance office.
Carrier, Underwriter, Insurer
The company that insures you.
Claim Form
A document that an insured person must complete as a part of the filing process. The form will usually ask specific questions relating to the medical treatment, previous history, etc.
Coinsurance
A provision of the insurance by which the covered person and the insurance carrier share in a specified ratio the eligible hospital or medical expenses resulting from a sickness or accident, (e.g. 80%:20% the carrier paying 80%, the insured person paying 20%).
Copayment
A specified dollar amount a Covered Person must pay for specified services.
Coordination of Benefits/Anti-Duplication Provision
Provision of the insurance designed to eliminate duplicate payments and provide the sequence in which coverage will apply when a person is insured under two or more health plans. This provision assures that no more than 100% of all incurred expenses will be paid by all insurance companies combined.
Deductible
The amount of out-of-pocket expenses that must be paid by the insured for health services before benefits become payable by the insurance carrier.
Dependent
The insured student's spouse residing with the insured student; or the insured student's unmarried child or children over the age of fourteen(14) days (including step children if dependent on the insured student), and under the age of twenty-six (26) years, who are not self-supporting and who reside with the Insured student.
Doctor
A licensed practitioner of the healing arts acting within the scope of his or her license and practice.
Effective Date
Date the insurance coverage commences.
Elective Surgery and Elective Treatment
Surgery or medial treatment which is not necessitated by a pathological or traumatic change in the function or structure in any part of the body.
Eligible Expenses
Usual and customary expenses that may be used as the basis for a claim under the terms of the insurance.
Emergency Admission
A hospital admission for inpatient hospital confinement for a condition which, unless promptly treated on an inpatient bases, would (1) put the patient's life in danger; or (2) cause serious damage to a bodily function of the patient.
Exclusions
Specified conditions or circumstances for which a policy does not provide benefits.
Hospital
An institution operating under the supervision of a licensed physician primarily for the care and treatment of injured and sick persons confined as inpatients, having organized facilities on the premises for diagnosis, major surgery and 24 hour-a-day nursing services but not primarily a place for alcoholics or drug addicts, not a nursing, rest or convalescent home.
Hospital Confinement
A medically necessary overnight confinement in a hospital when room and board and general nursing care are provided and a per diem charge is made by the hospital.
Open Enrollment
Time period when students are eligible to enroll for coverage without having to prove insurability.
Out-of-Pocket
Includes the coinsurance payable by the claimant and any co-payments paid by the claimant. Out of Pocket does not include any excluded amounts ( including but not limited to amounts over Reasonable and Customary or Usual and Customary and charges not covered by the policy) or amounts that exceed the maximum benefit allocation as listed in the Schedule of Benefits.
Pre-existing Condition
A pre-existing condition is a condition for which the person received medical treatment or advice, or which was diagnosed in the six months preceding the effective date of the person's coverage. An accidental injury sustained during the six months preceding the effective date of the persons coverage will also be considered a pre-existing condition.
Surgical Procedure
Cutting, suturing, treating burns, correcting fracture, reducing a dislocation, manipulating a joint under general anesthesia, electrocauterizing, tapping (paracentesis), applying plaster casts, administering pneumothorax, endoscopy or injecting, sclerosing solution.
Therapy Services (Medical)
Services used to treat or promote recovery from illness/injury.
A) radiation therapy is treatment using x-ray, radium, cobalt, or high energy particle sources. Radiation therapy includes rental or cost of radioactive materials. Diagnostic services requiring use of radioactive materials are not radiation therapy.
B) Chemotherapy is treatment of malignant disease by using chemical or biological antineoplastic agents.
Treatment
Medical care provided by means of consulting any medical provider about symptoms resulting from injury or sickness. Also includes, (but is not limited to) care by means of diagnostic procedures (i.e., x-rays, lab, surgery); the taking of medications; therapy (physical, mental health, etc.); or the use of any appliance (mental or dental).
Usual and Customary Charge/Reasonable and Customary
The charge for the offered service or supply usually made by the provider when there is no insurance, not to exceed the prevailing charge in the area for a service of the same nature and duration and performed by a person of similar training and experience, or for a substantially equivalent supply.
How do I get an insurance card?
Insurance cards are mailed at the beginning of each semester with your plan materials. If you have lost your card you can request a new one at the Student Insurance Office or print one online by clicking here.
How do I provide input about suggested changes in plan benefits and coverage?
Your input about plan benefits and coverage is important! We welcome your comments and suggestions.
Why do I have to pay the student health fee to be enrolled on the student insurance plan?
The insurance plan is designed to work in conjunction with the student fee funded services provided at the CSU Health Network.
Can I use part of my $100 annual flex benefit to pay for the summer health fee?
Yes.
Why do the premiums for students, spouses/domestic partners and dependent children vary?
Premium rates for students, spouses/domestic partners, and dependent children up to age 26 are calculated separately by the underwriter and are based on an actuarial analysis of claims history for each group.
I was enrolled in the plan during the spring semester. I will not be attending summer school. Do I have plan coverage during the summer?
Students who are enrolled in the plan in the spring have coverage that extends through the subsequent June, July and a portion of August. Refer to the coverage date information provided above for specific coverage dates for the specific plan year.
I am a graduate student taking less than 6 credits so I am not subject to the mandatory insurance requirement. Why have I been automatically enrolled and billed for the Student Insurance Plan?
Because credit hours can vary during the open enrollment period, all graduate students who are enrolled in at least one credit hour (except continuous registration students) are automatically enrolled in the plan. Domestic Graduate Students who are enrolled in less than six credit hours are not subject to the mandatory insurance requirement and can contact the student insurance office at any time during the open enrollment period to change their enrollment status. Under the terms of our insurance provider, no changes can be made to enrollment status once the open enrollment period has ended and no changes or refunds from our insurance provider can be made after that time.
I am an undergraduate student and I accidentally enrolled in the plan during the registration ready process. I am already covered by my parent's insurance plan. How do I get off the student insurance plan?
Domestic undergraduate students are not subject to the mandatory insurance requirement and can contact the student insurance office at any time during the open enrollment period to change their enrollment status. Under the terms of our insurance provider, no changes can be made to enrollment status once the open enrollment period has ended and no changes or refunds from our insurance provider can be made after that time.
Does my spouse or dependent children need to reenroll each semester?
Yes. Your spouse and dependents need to be reenrolled each semester. Coverage dates are dependent on the date of enrollment. Please refer to the insurance brochure regarding the effective date of coverage given the date of enrollment.
Why are all International Students required to have a specified level of health insurance coverage?
The Board of Governors of the Colorado State University System has mandated that a specified level of health insurance coverage be required for all International Students so that student's educational success is not hindered by unforeseen medical problems or expenses. More information on this requirement is available at the Office of International Programs and can be accessed here.
Why does the University require Graduate Students who are enrolled in 6 or more resident instruction credits to have a specified level of health insurance coverage?
In order to minimize the health risks that may impact a student's ability to complete his or her graduate studies, the Board of Governors of the Colorado State University System has mandated that all CSU graduate students enrolled in 6 or more resident instruction units be covered by a comprehensive health insurance plan. More information about this requirement is available from the Graduate School and can be accessed here.
I am a graduate student and was waived from the mandatory insurance requirement in the fall because I was covered under another plan that was approved as comparable coverage by the CSU student insurance office. Do I need to submit another waiver request in the spring semester if I was approved for a waiver in the fall semester?
No.
I have the same plan and coverage this year as I did last year. Do I need to submit proof of coverage and plan documents again?
Yes. Because plan enrollment and plan benefits can vary from year to year proof of coverage and insurance plan documents outlining benefits must be submitted each year when applying for a waiver due to comparable coverage.
Should a student have a referral to use other providers?
Yes. Your first and primary source for medical care under the Student Insurance Plan is at the CSU Health Network as you will receive the most benefit from your plan by beginning here. Depending upon need, you may be referred to an outside provider for additional care. Using our referral system can assist you with finding in-network providers under the off campus care benefit which will maximize your benefits.
I am enrolling in an outside plan and need a letter of credible coverage or proof of prior coverage. How to I obtain such a letter?
The student insurance office can help you with this. See above tab titled Student Health Insurance Office.