Florida Memorial University 2017-2018 Student Health Plan

2017-2018 STUDENT HEALTH PLAN

Florida Memorial University believes it is important that all students maintain health care coverage to help ensure academic success and well-being. The University is pleased to offer our students a Health Plan that provides excellent levels of health coverage, with low out-of-pocket costs when compared to plans offered commercially or through the ACA marketplace.

COVERAGE REQUIREMENT

All registered full-time undergraduate, international students, and athletes are automatically enrolled in the new 2017-2018 Student Health Plan A and B, effective August 1, 2017 to July 31, 2018. The cost is included in your tuition and billed to your student account each academic semester.

Students who have adequate health care coverage may elect to waive out of Plan B by completing the online waiver request. If you do not complete a waiver request by the semester deadline, you will automatically be enrolled for the full academic year and the cost of this plan will be charged to your student account. There are no refunds or cancellations (unless you are no longer a student) after the deadline.

Students may not waive out of Plan A.International Students may not waive out of Plan A or B. Graduate and part-time students may elect to purchase this plan on a voluntary basis.

ABOUT THE PLANS

Plan Information

BENEFITS AT A GLANCE

About This Plan

PLAN SUMMARY DOCUMENT

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Plan A - Limited Supplemental Limited Health and Injury Benefits

PLAN A is intended to cover 100% of acute medical care when treated at the Jesse Trice Student Health Center, located on the FMU campus. Full-time undergraduate students, international students, and athletes are automatically enrolled in this plan at the time of registration. The cost of this coverage is billed to your student account in two equal semester payments. Students may not waive out of Plan A.

This plan DOES NOT include coverage for inpatient hospitalization or any other specialty care.

This plan includes:

    • A limited outpatient medical and pharmacy benefit that will help supplement your out of pocket cost under your primary health care plan, i.e. deductibles, co-insurance and copayments.
    • Accident Coverage up to $10,000 per Injury (Non-Sports related injuries).
    • Accident Coverage up to $25,000 per Injury (Intercollegiate Sports related injuries).
    • 24 hour, 7 days a week access to a registered nurse and physician services.

View Plan Coverage

 

Plan B - Comprehensive Primary Medical Health and Injury Benefits

PLAN B is to serve as a student’s primary health care plan and provides more comprehensive inpatient hospital, outpatient primary and specialty coverage, and pharmacy benefits.  Students who do not have other adequate health insurance while attending Florida Memorial University are required to have Plan B.

Students with an approved waiver will receive a credit for the cost of this plan of $322.50 per semester that will be applied to your student account after the September 10th waiver deadline.  If you have questions about this, please send an email to info@aisstudentinsurance.com.

This plan includes:

    • The cost for medical services rendered at the Jesse Trice Student Health Center.
    • In-network medical expenses are covered at 80% after the $150.00 plan year deductible has been satisfied.
    • Coverage for preventative and wellness benefits at 100%, no copay or deductible applies.
    • 24 hour, 7 days a week access to a registered nurse and telemedicine physician services.
    • Worldwide coverage and travel assistance services while traveling or studying abroad.

View Plan Coverage

Florida Memorial University's Student Health Center

The Student Health Services health forms include a Statement of Health Insurance Coverage Form, Meningitis Information/Declination, Physical Examination, and Immunization Documentation forms.

Download the Health Forms

The Jesse Trice Student Health Clinic provides minimal healthcare services to full-time students.  Students can be evaluated and treated for acute and chronic medical conditions as well as guidance on practices that promote good health and disease prevention.   You are advised and encouraged to visit the clinic for information on the services offered before you get sick. The clinic staff includes a Nurse Practitioner, Registered Nurse, Medical Assistant and a Customer Service Representative.

Click Here For More Information

Location & Hours
The on-site clinic is located in Building 3.  Business hours are Monday to Friday from 8.00 am to 5.00pm

Appointments
Appointments may be made by calling 305-626-3110.  Walk-ins are seen on a "first come, first, serve basis." Students are evaluated by the nurse and based upon the severity of illness may be immediately seen by a provider, given an appointment for a later time, or referred to a specialist or hospital. Students with scheduled appointments have priority over walk-ins unless there is a life-threatening emergency.

Locate Off-Campus Providers


WAIVER PROCESS

The deadline to waive out of the FMU Student Health Plan B, for Fall 2017-18 was September 6, 2017.   The online waiver application with re-open for the Spring semester on November 15, 2017 and will close on February 1, 2018.  Students who waived out for the Fall semester do not need to waive out again for the Spring semester.

APPROVED WAIVERS:  If you have an approved waiver and want to find out the status of the credit that will be applied to your student account or refund check, please contact FMU Student Accounts at  (305) 626-3737 or send an email to katrenia.blue@fmuniv.edu.

Waiver Requirement

Students may request to waive out of Plan B if the following criteria below are met:

1. You will be required to upload a copy (front and back) of your health insurance plan ID card when completing the online waiver request.
2.The claims administrator of the plan is based in the United States and has a U.S. telephone number and address for submission of claims and the insurance policy has not been issued outside the U.S.
3. The plan provides in-network coverage for non-emergency health care, hospitalization, physician visits, specialty visits and mental health benefits within 50 miles from campus.
4. The plan provides coverage for prescription medication.
5. The annual plan deductible does not exceed $1,000.

Out-of-state Medicaid and state Children’s Health Insurance Plans, HMOs, and Kaiser Permanente plans may not cover non-emergency care in this area. If this is the case, you will not qualify for a waiver. Please contact your medical insurance carrier to confirm that your insurance covers non-emergency care and that you have a deductible small enough to allow you to afford your portion of the bill.

International students holding an F1 or J1 visa may not waive out of Plan A or Plan B.

If the waiver submitted does not meet the waiver criteria, you will be enrolled in Plan A and Plan B.

Waiver Request Form

The deadline to waive out of the FMU Student Health Plan for fall, 2017 was September 6, 2017.

Click Here To Waive Plan B or C

If you lose your health insurance plan mid-year, you may elect to enroll in Plan B at any time throughout the year due to a qualifying event.  For more information, contact Academic Insurance Solutions to enroll at (888) 776-9920.

Request Waiver Status

ATHLETIC INJURY COVERAGE

Plan Information

Florida Memorial University provides an excess medical athletic injury policy for all (full or part-time) of its intercollegiate athletes to cover injuries sustained during official intercollegiate athletic activities.

This policy, at no cost to the athlete, provides secondary coverage; that is, it pays after the primary insurance carrier has paid their portion.

Excess Provision. No benefit under this Plan is payable for any expense incurred for Injury or Sickness which is paid or payable by other valid and collectible insurance or under an automobile insurance policy. Covered medical expenses exclude amounts not covered by the primary insurer due to penalties imposed on the Covered person for not complying with plan provisions or requirements.

BASIC PLAN SUMMARY - MEDICAL EXPENSES INCURRED UP TO $25,000 (Per Injury)

Plan Benefit Summary (coverage up to $25,000)


CATASTROPHIC PLAN SUMMARY - MEDICAL EXPENSES FROM $25,000 (Per Injury) to $5,000,000 (Per Injury)

Plan Summary (from $25,000 to $5,000,000)

How To File A Claim

Florida Memorial University provides an excess medical athletic injury policy for all of its intercollegiate athletes to cover injuries sustained during official intercollegiate athletic activities. This policy, at no cost to the athlete, provides secondary coverage; that is, it pays after the primary insurance carrier has paid their portion.

Complete the Online Claim Form

PLEASE BE SURE TO FOLLOWING THESE INSTRUCTIONS TO HAVE YOUR CLAIMS PAID PROPERLY:

ALL CLAIMS MUST BE FILED WITHIN 180 DAYS OF INJURY IN ORDER FOR VALID CLAIMS TO BE PAID.

  • This claim form must be signed by you and a school official.
  • All athletes must file claims with any other primary insurance that you are insured under (if applicable). This means that any claims for athletic injury must first be filed with the student, parent or guardian’s insurance plan or any other valid and collectible medical insurance coverage. Not following this step will delay the claim process.
  • Be sure to submit a copy of this form to the claims address listed below along with copies of all itemized bills and any Explanation of Benefits (EOB) from any other insurance company that has processed your bills.  The FMU student insurance WILL NOT pay your claims if you have other insurance and the other insurance company has not processed your claims.
  • The FMU student insurance will pay the charges for eligible injuries which the other primary coverage has not covered or fully paid, up to the usual and customary charge in our area.
  • In order to meet filing guidelines, all primary insurance carriers’ explanation of benefits (EOBs) must be mailed to the FMU student insurance claims office within one year of the date of service or your claims will be denied.
  • The Claim's Department will coordinate all other aspects of the claim with the athlete/parent/guardian.

CATASTROPHIC CLAIMS - MEDICAL EXPENSES THAT EXCEED $25,000 

The student must complete the Catastrophic Intercollegiate Sports Accident Claim Form if medical expenses exceed $25,000.

Catastrophic Plan Claim Form

Check Claim Status

To view your coverage information, check to see if your claims have been filed and for claim status, be sure to create your online member account.correspondence.

FIRST TIME USERS:   

  1. To begin, click on the button below and then select "Employee";
  2. Then type in your FMU student email address.
  3. Complete all of the information requested.  If you do not have a social security number, please type in your government ID or student ID number.

Create Member Account

ALREADY HAVE AN ACCOUNT:

Login Here

For assistance with creating your online member account, please call 1 (844) 223-2607.

ONCE ENROLLED IN THE PLAN

Print an ID Card

Students on Plan B or C ONLY may print an ID card by clicking on the link below.  Students on the supplemental Plan A, do not need an ID card.

This card is not a guarantee of coverage or benefit payment.  The provider will verify coverage at the time of your visit with the information provided on this card.

  1.  Fill in your name and FMU student ID number (omit the "P" and it should be a 9 digit number starting with zeros).
  2. Then hit the "Merge Document" button.
  3. It will then generate a PDF of your ID Card for you to print or save to your computer or phone.

Generate an ID Card

Create Your Member Account

To view your coverage information, check to see if your claims have been filed and for claim status, be sure to create your online member account.correspondence.

FIRST TIME USERS:   

  1. To begin, click on the button below and then select "Employee";
  2. Then type in your FMU student email address.
  3. Complete all of the information requested.  If you do not have a social security number, please type in your government ID or student ID number.

Create Member Account

ALREADY HAVE AN ACCOUNT:

Login Here

For assistance with creating your online member account, please call 1 (844) 223-2607.

Find an In-Network Preferred Provider

Aetna Signature Administrators (ASA) has a new Find a Provider tool that does not require you to select a plan option.

Click Here to Begin Search

Then click on Medical to begin your search.

Please note, Dental is not included in this student health plan.  Dental is sold separately.

File a Claim

To submit an Online Claim Form

Click Here to Submit Claim

Mail Paper Claims should be mailed to:

Continental Benefits, PO Box 3610, Brandon FL 33509-3610

For Claim Questions, call: 1 (844) 223-2607

Optional Dental and Vision

Click on the links below if you are interested in purchasing optional dental or vision coverage.

Contact Information

 

 

For questions about this plan, please call Academic Insurance Solutions at: 1 (888) 776-9920.

To pre-certify call:  1 (800) 641-5566
Pre-certification must be made prior to an inpatient hospital admission (or within 48 hours if an emergency).
Failure to pre-certify may result in reduced benefits.

TRAVEL ABROAD COVERAGE

Cigna Health when Traveling Abroad Student Health – Anytime, Anywhere and from Any Device. A personal health crisis can strike at any time, which is why the Student Educational Benefit Trust (SEBT) is collaborating with Cigna Global Health Benefits to offer customer service that stretches beyond borders, across the globe and around the clock. Cigna’s Global Customer Service Centre is open 24/7 to provide services on demand, so our model is always there to help students with any situation that might arise. From multilingual assistance with verification of benefits, payment guarantees, physician and hospital referrals, to coordination with emergency medical assistance providers. Students covered under a SEBT primary plan are automatically enrolled into Cigna Global Health Benefit. To activate coverage prior to departure, contact Cigna’s Global Service Centre at 800-243-1348