Wellesley College Student Health Insurance Plan | University Health Plans, Inc.

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margin-bottom:11px"><u><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">Eligibility</span></span></b></span></span></span></u></p> <p style="margin-bottom:11px"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">Per Massachusetts State Law, all students including Davis Scholars are required to enroll in the Wellesley College Student Health Insurance Plan or be covered by a health insurance plan with comparable coverage. To ensure compliance with Massachusetts law, Wellesley College students are automatically enrolled in and billed for the Student Health Insurance Plan. To read the details on this law, please click </span></span><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif"><a href="https://betterhealthconnector.com/wp-content/uploads/ship/Regulations/956CMR8_Student_Health_Regs.pdf"><span style="color:blue">here</span></a></span></span><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">.</span></span></span></span></span></p> <p align="center" style="text-align:center; margin-bottom:11px"><br /> <u><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">Plan Highlights</span></span></b></span></span></span></u></p> <p style="margin-bottom:11px"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">The 2024-2025 Wellesley College Student Health Insurance Plan (SHIP) is provided by <b>Blue Cross Blue Shield of Massachusetts</b>. The plan is ACA-compliant and includes access to Blue Cross Blue Shield's national PPO network of providers. Students do not have to select a primary care physician and referrals are not required. The SHIP includes the Hospital Choice Cost Sharing benefit feature where hospitals in Massachusetts are grouped into two different cost-sharing levels. When students receive hospital services, the amount they pay out-of-pocket is based on that hospital’s cost-sharing level. Information about the Hospital Choice Cost Sharing benefit can be found by clicking </span></span><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif"><a href="https://www.bluecrossma.com/common/en_US/pdfs/New_SOB/55-0247_HCCS_Fact_Sheet.pdf"><span style="color:blue">here</span></a></span></span><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">.  For a list of high and low-cost-share hospitals, please click </span></span><a href="https://home.bluecrossma.com/collateral/sites/g/files/csphws1571/files/acquiadam-assets/55-1508_HCCS_Hospital_List.pdf"><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif"><span style="color:blue">here</span></span></span></a><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">.</span></span></span></span></span></p> <p style="margin-bottom:11px"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">Wellesley has partnered with University Health Plans to administer the plan and help with waiver, enrollment, or benefit-related questions. University Health Plans can be reached at 833-251-1116 or </span></span><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif"><a href="mailto:info@univhealthplans.com"><span style="color:blue">info@univhealthplans.com</span></a></span></span><i><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">. </span></span></i></span></span></span></p> <p align="center"><br /> <span class="text-medium"><span class="text-small"><strong><u>Cost and Coverage Periods</u></strong></span></span></p> <table align="center" border="1" cellpadding="1" cellspacing="1" style="width: 500px;"> <thead> <tr> <th scope="col"> </th> <th scope="col">Annual Students</th> <th scope="col">New Spring Students</th> </tr> </thead> <tbody> <tr> <td>Coverage Dates</td> <td style="text-align: center;">8/15/24 - 8/14/25</td> <td style="text-align: center;">1/1/25 - 8/14/25</td> </tr> <tr> <td>Insurance Cost</td> <td style="text-align: center;">$3,860</td> <td style="text-align: center;">$2,417</td> </tr> <tr> <td><strong>Petition to Waive Deadline</strong></td> <td style="text-align: center;"><b>October 3, 2024</b></td> <td style="text-align: center;"> <p><b>January 3, 2025</b></p> </td> </tr> </tbody> </table> <p align="center" style="text-align:center; margin-bottom:11px"><br /> <u><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">Enrollment Process</span></span></b></span></span></span></u></p> <p style="margin-bottom:11px"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.5pt"><span style="background:white"><span style="font-family:"Open Sans",sans-serif">Students who wish to enroll in the Wellesley College student health insurance plan do not need to take any action and will be automatically enrolled by the College. </span></span></span></span></span></span></p> <p align="center" style="text-align:center; margin-bottom:11px"><br /> <u><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">Waiver Process</span></span></b></span></span></span></u></p> <p style="margin-bottom:11px"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.5pt"><span style="background:white"><span style="font-family:"Open Sans",sans-serif">If you are covered by a comprehensive health insurance plan you can opt out of the Wellesley College SHIP by completing the <strong><span style="font-family:"Open Sans",sans-serif">waiver form, </span></strong>located in the left-hand side navigation menu. Before waiving, compare the cost, coverage, and benefits of the SHIP to your existing plan.  To waive, your plan must meet the below requirements. </span></span></span></span></span></span></p> <ul> <li style="margin-bottom:11px"><span style="font-size:11pt"><span style="background:white"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">The policy must be a US-filed and approved, ACA (Affordable Care Act) compliant health insurance plan. <i>International insurance plans, travel insurance, and short-term limited-duration plans are not accepted.</i></span></span></span></span></span></span></span></li> <li style="margin-bottom:11px"><span style="font-size:11pt"><span style="background:white"><span style="line-height:normal"><span style="tab-stops:list .5in"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">Your plan must provide access to doctors, specialists, hospitals, labs, pharmacies, and mental health/behavioral health providers in the Wellesley College campus area without restriction or limitation. <b>Please note, </b>if you are enrolled in an out-of-state Medicaid, HMO, or EPO your coverage may not be sufficient in Massachusetts. Many out-of-state plans do <b>not</b> provide comprehensive benefits outside of the home service area, and urgent or emergency-only coverage in Massachusetts is not sufficient and does not meet the SHIP waiver requirements. For your benefit, a comparison worksheet has been provided for you below. Please review and complete the comparison to confirm your plan’s coverage before submitting the waiver form.</span></span></span></span></span></span></span></li> </ul> <p style="margin-bottom:11px"> </p> <p style="text-align: center"><a class="box medium-box uppercase text-large" href="/pdf/Wellesley-Comparison-Worksheet-2425.pdf" target="_blank">Comparison Worksheet</a></p> <p style="margin-bottom:16px"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.5pt"><span style="background:#ffff33"><span style="font-family:"Open Sans",sans-serif">Students who do not submit an enrollment or waiver form by the deadline will be enrolled in the SHIP retroactively to the policy effective date and responsible for the insurance premium.</span></span></span></span></span></span></p> <p align="center" style="text-align:center; margin-bottom:11px"><u><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">International Students</span></span></b></span></span></span></u></p> <p style="margin-bottom:11px"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">All international students will be automatically enrolled in the SHIP and do not need to take any action.</span></span></b><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif"> You can access your health insurance membership information in the left-hand side navigation menu. International students can only waive if they are enrolled in a <span style="background:white">US-filed and approved, ACA (Affordable Care Act) compliant plan that provides both emergency and non-emergency care in Massachusetts, specifically the Wellesley College campus area. </span><b>Please note,</b> health insurance plans marketed solely to international students are often not filed in the US and have limited benefits and/or coverage periods that do not comply with the Massachusetts Student Health Plan Regulations and the Wellesley College waiver requirements. ISO, PSI, Student Medicover, PGH Global, DIANins, and NYIS Insurance are examples of companies that <b><i>do not</i></b> meet the waiver requirements.</span></span></span></span></span></p> <p align="center" style="text-align:center; margin-bottom:11px"><br /> <span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif"><u>Qualifying Event Enrollment Process</u></span></span></b></span></span></span></p> <p style="margin-bottom:11px"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">Students who waived the SHIP may qualify for special enrollment rights if they incur an involuntary loss of other coverage. The Qualifying Event Enrollment Form can be found in the navigation menu on the left-hand side of this page. To request a premium quote, contact University Health Plans at 800-437-6448 or </span></span><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif"><a href="mailto:info@univhealthplans.com"><span style="color:blue">info@univhealthplans.com</span></a></span></span></span></span></span></p> <p style="margin-bottom:11px"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.5pt"><span style="font-family:"Open Sans",sans-serif">To enroll, you must submit an enrollment form, a letter from your prior insurance company documenting your loss of coverage, and payment <b>within 60 days of the qualifying event. </b>If all items are received by the deadline coverage will be effective as of the first day without coverage under your prior plan.<b> </b></span></span></span></span></span><br />  </p> <p style="text-align: center;"><strong><u>Spring Termination Request Process</u></strong></p> <p>Due to the Massachusetts Student Health Insurance Plan Regulation, Wellesley College is required to allow students to terminate their SHIP mid-academic year if the student is newly eligible for a <u>subsidized</u> Massachusetts Health Connector Plan or MassHealth before the start of the Spring Term (before 1/1/25) or if a student will no longer be attending the College in the Spring Term. Students who meet the spring termination criteria may submit the Spring Termination Request Form l<span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-size:10.5pt"><span style="background:white"><span style="font-family:"Open Sans",sans-serif">ocated in the left-hand side navigation menu in November 2024. </span></span></span></span></span></span>The deadline to submit the Spring Termination Request Form is January 31, 2025. </p> </div> </div> <div class="col-sidebar col-xs-6 col-xs-pull-18 col-lg-7 col-lg-pull-17">  <div class="sidebar__menu" id="main-menu" tabindex="-1"> <div class="sidebar__logo"><img src="/logos/WC1213.png" alt="Wellesley College"></div> <ul> <li><a href="/letters/letter.cgi?group_id=250">Introduction</a></li> <li><a href="#menu-contact-info-250" class="lightbox-small">Contact Information</a></li> <li> <a href="https://home.bluecrossma.com/coronavirus" target="_blank">BCBSMA COVID-19 Updates</a>  </li> <li><a href="/faqs/faq.cgi?group_id=250">FAQs</a></li> </ul> <h2>Student Health Plan</h2> <ul> <li><a href="/custom/Wellesley_Waiver.html?27638188">Waiver Form</a></li> <li><a href="#enrollment-plan-changes" id="enrollment-form-link">Enrollment Information</a></li> <li><a href="/secure/enrollment.cgi?group_id=250">Dependent Enrollment Form</a></li> <li><a href="/secure/waiver.cgi?group_id=552">Spring Termination Request Form</a></li> <li class="expanded"> <h3>Qualifying Event Enrollment</h3> <ul> <li><a href="/pdf/Wellesley-Student-Qualifying-Event-Enrollment-Form-2223.pdf" target="_blank">Student</a></li> <li><a href="/pdf/Wellesley-Dependent-Qualifying-Event-Enrollment-Form-2223.pdf" target="_blank">Dependent</a></li> </ul> </li> <li class="expanded"> <h3>Benefit Information</h3> <ul> <li><a href="/pdf/Wellesley-Benefits-Coverage-2425.pdf" target="_blank">24-25 Summary of Benefits <span class="no-wrap">and Coverage</span></a></li> <li><a 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href="/worldwide_coverage/Wellesley.html">Worldwide Providers &<br/> Travel Assistance</a></li> <li class="expanded"><h3>Prescription Info</h3> <ul>  <li><a href="https://home.bluecrossma.com/medication/" target="_blank">Medication Look Up</a></li> <li><a href="/brochures_pdf/RxClaimForm.pdf" target="_blank">Prescription Claim Form</a></li> </ul></li>  <li><a href="/secure/bcbs_lookup.cgi?group_id=250">Insurance ID Card</a></li> </ul> <div>  </div> <h2>Optional Plans</h2> <ul> <li><a href="/letters/letter.cgi?group_id=161">Massachusetts Delta Dental Plans</a></li> <li><a href="/letters/letter.cgi?group_id=170">VSP Vision Care Plan</a></li> <li><a href="https://assurantrenters.com?utm_source=dormdefense&utm_medium=uhp" target="_blank">Renters Insurance</a></li> </ul> <h2>Additional Information</h2> <ul> <li><a href="https://www.wellesley.edu/healthservice" target="_blank">Newton-Wellesley Collegiate Health</a></li> <li><a href="/insurance_options/Wellesley.html" target="popup:width=750,height=600,resizable=yes,scrollbars=yes,menubar=yes:InsuranceOptions">Insurance Info for Graduating Students and Dependents</a></li> </ul>  <div><div class="hidden"> <div id="enrollment-plan-changes" style="padding: 20px;"> <p>Students who wish to enroll in the Wellesley College student health insurance plan do not need to take any action and will be automatically enrolled by the College.</p> <p>Hard copies of your BCBS insurance ID card will <em><strong>not</strong></em> be mailed. You can look up your membership information by clicking <strong>Insurance ID Card</strong> located on the left-hand side of this page. You can also download the <strong>MyBlue Member app</strong> at: <a href="http://myblue.bluecrossma.com/student" target="_blank">http://myblue.bluecrossma.com/student</a> to access your electronic ID card.</p> </div> </div> <script> jQuery(function($){ $('#enrollment-form-link').fancybox({ //maxWidth: 1000, //maxHeight: 650, maxWidth: 800, maxHeight: 400, fitToView: false, width: '90%', height: '90%', autoSize: false, openEffect: 'none', closeEffect: 'none', title: '' }); }); </script></div> </div> <div class="hidden"><div id="menu-contact-info-250" style="padding: 20px"> <h1 style="text-align: center;">Contact Information</h1> <p>For <strong>waiver</strong>, <strong>enrollment</strong>, <strong>eligibility</strong>, <strong>general benefit questions</strong> or <strong>plan issues</strong><br /> contact University Health Plans at 833-251-1116.</p> <p>For <strong>specific benefit or claims questions</strong><br /> contact Blue Cross Blue Shield of Massachusetts at 888-753-6615.</p> </div> </div>  </div> </div> </div> </div>  <footer class="footer"> <div class="container"> <div class="row"> <div class="footer__col">   </div> <div class="footer__col">  <div class="footer__broker"> <p>University Health Plans Broker License # 000123936000<br> William E. 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