Bridgewater State University Student Health Insurance Plan

<!doctype html> <html class="no-js" lang="en"> <head> <meta charset="utf-8"> <meta http-equiv="X-UA-Compatible" content="IE=edge"> <title>Bridgewater State University Student Health Insurance Plan | University Health Plans, Inc.</title>  <link rel="stylesheet" href="/themes/2018/bootstrap/css/bootstrap.min.css?2024-03-19">   <link rel="stylesheet" href="/themes/2018/css/proxima-nova.css?20221128">  <link rel="stylesheet" href="/themes/2018/css/styles.css?2024-08-20"> <link rel="stylesheet" href="/themes/2018/css/legacy.css?2024-08-20"> <link rel="stylesheet" href="/themes/2013/plugins/fancybox/source/jquery.fancybox.css"> <link rel="stylesheet" href="/themes/2013/css/forms.css?2022-07-21"> <link rel="stylesheet" href="//ajax.googleapis.com/ajax/libs/jqueryui/1.11.4/themes/smoothness/jquery-ui.css" />    <script src="/themes/2018/js/vendor/modernizr-3.5.0.min.js"></script>  <script src="https://ajax.googleapis.com/ajax/libs/jquery/3.6.0/jquery.min.js"></script> <script>window.jQuery || document.write('<script src="/themes/2018/js/vendor/jquery-3.6.0.min.js"><\/script>')</script> <script src="https://code.jquery.com/jquery-migrate-3.4.0.js"></script> <script src="//ajax.googleapis.com/ajax/libs/jqueryui/1.11.4/jquery-ui.min.js"></script>  <script type="text/javascript" src="/themes/2013/plugins/fancybox/source/jquery.fancybox.pack.js"></script> <script src="/js/popup.js"></script> <script src="/themes/2018/js/plugins.js"></script> <script src="/themes/2018/js/script.js?2023-04-25"></script> <script src="/themes/2018/js/products.js?2021-05-21"></script>  <script src="/themes/2018/bootstrap/js/bootstrap.min.js"></script>     </head> <body> <a href="#main-content" class="visually-hidden--focusable">Skip to main content</a> <a href="#main-menu" class="visually-hidden--focusable">Skip to main menu</a> <div class="body"> <header class="header"> <div class="container"> <div id="header__logo"><a href="/"><img src="/themes/2018/img/logo.svg" alt="Risk Strategies - University Health Plans" height="83"></a></div> <div id="header__legacy-logo" style="display: none;"><a href="/"><img src="/themes/2018/img/legacy-logo.svg" alt="Risk Strategies - University Health Plans" height="83"></a></div> <nav class="header__menu"> <ul class="clearfix"> <li id="header__about-link"><a href="/about/">About Us</a></li> <li id="header__contact-link"><a href="/contact/">Contact Us / FAQs</a></li> <li id="header__news-link"><a href="/healthcare-news/">Healthcare News</a></li> <li id="header__products-link" class="expanded"><a href="/products/" class="btn btn-primary">Additional Products & Services</a> <div class="header__submenu container"> <div class="products__all-link"><a href="/products/" class="btn btn-secondary">View All Products & Services</a></div> <div class="products"> <div class="row">  <div class="products__col col-xs-8"> <div class="products__item"> <h3>Dental Insurance<div style="font: .5em ProximaNova-Light, 'Open Sans', Helvetica, Arial, sans-serif; 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You can access the Waiver Form or Enrollment Form by clicking on the appropriate box on the left. However, it is VERY important that you review the information below before proceeding to the Waiver Form.</p> <p>Full time or three-quarter time students (graduate and undergraduate) at Bridgewater State University, who are enrolled in a health care plan or who are covered by a parent/spouse’s health care plan, which meets the minimums set forth in Massachusetts Law C.15A, s. 18 (available at <a href="http://www.mahealthconnector.org" target="_blank">www.mahealthconnector.org</a>), use the Waiver Form found on this site to waive for the 2024-2025 Student Health Insurance Plan. The Student Health Plan for the 2024-2025 Policy Year is through Blue Cross Blue Shield of Massachusetts.</p> <table align="center" class="content-table gray-border"> <caption><span class="text-medium">Insurance Cost and Coverage Periods</span></caption> <thead> <tr> <td class="empty"> </td> <th scope="col">Annual</th> <th scope="col">Spring/Summer</th> </tr> </thead> <tbody> <tr> <th scope="row" style="text-align: left;">Coverage Dates</th> <td style="text-align: center;">8/1/2024 - 7/31/2025</td> <td style="text-align: center;">1/1/2025 - 7/31/2025</td> </tr> <tr> <th scope="row" style="text-align: left;">Premium Cost</th> <td style="text-align: center;">$3,941.00</td> <td style="text-align: center;">$2,301.00</td> </tr> <tr> <th scope="row" style="text-align: left;">Deadline Dates</th> <td style="text-align: center;">September 20, 2024</td> <td style="text-align: center;">February 14, 2025</td> </tr> </tbody> </table> <p style="margin-bottom:11px">Bridgewater State University 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 833-251-1736 or <a href="mailto:info@univhealthplans.com">info@univhealthplans.com</a>.</p> <p>Bridgewater State University does not allow the following classes of students to waive off the QSHIP plan. If the student falls under one of the following categories they are ineligible for waiver and will be automatically enrolled:</p> <ul> <li>student with coverage from insurance carriers outside the U.S. and/or coverage by foreign National Health Services programs</li> <li>students with a health insurance plan that provides coverage through a closed network of providers not reasonably assessable in the area where the student attends school, for all but emergency services; or</li> <li>students with a Health Safety Net, MassHealth Limited, or Children’s Medical Security Plan.</li> </ul> <p>Please note, in addition, the following students are not eligible to use this on-line waiver system:</p> <ul> <li>Undergraduate students taking less than 9 credits are not eligible for BSU Student Health Insurance and therefore need not waive.</li> <li>Graduate students taking less than 7 credits are not eligible for BSU Student Health Insurance and therefore need not waive.</li> </ul> <div>Very specific information is necessary to complete a waiver. Please be sure that you know the answers to the following questions, BEFORE LOGGING IN. Please consult your insurance company if you do not know the answers to these questions. [For example, the insurer’s address is required. Some companies do not list an address on their membership card.]</div> <ul> <li>Does your plan provide coverage for medically necessary care in the Bridgewater area, and out of state?</li> <li>Does your insurance provide coverage for the entire academic year without restriction?</li> <li>Does your plan provide coverage with no maximum benefit?</li> <li>Does your plan provide comprehensive health care which includes primary and preventive care, hospitalization, surgical services, ambulatory patient services, emergency services?</li> <li>Does your plan include mental health services which meet at least the minimum required by Massachusetts law?</li> <li>Does your plan provide coverage for pre-existing illnesses?</li> <li>Your plan may not be Health Saftey Net, MassHealth Limited, or Children’s Medical Security Plan.</li> </ul> <p>Students who waived the SHIP may qualify for special enrollment rights if they incur a loss of other coverage. To request enrollment and premium quote, contact the University Health Plans at 833-251-1736 or email info@univhealthplans.com.</p> <p>Sincerely,</p> <p>Student Accounts<br /> Bridgewater State University</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/BridgewaterSC.png" alt="Bridgewater State University"></div> <ul> <li><a href="/letters/letter.cgi?group_id=212">Introduction</a></li> <li><a href="#menu-contact-info-212" 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=212">FAQs</a></li> </ul> <h2>Student Health Plan</h2> <ul>  <li><a href="#enrollment-plan-changes" id="enrollment-form-link">Spring 2025 Enrollment Form</a></li>  <li class="expanded"> <h3>Benefit Information</h3> <ul> <li><a href="#benefits-coverage-changes" id="benefits-coverage-link">24-25 Summary of Benefits <span class="no-wrap">and Coverage</span></a></li> <li><a href="#benefits-summary-changes" id="benefits-summary-link">24-25 Plan Highlights</a></li> <li><a href="/pdf/MSU-Benefits-Coverage-2324.pdf" target="_blank">23-24 Summary of Benefits <span class="no-wrap">and Coverage</span></a></li> <li><a href="/pdf/MSU-Benefits-Summary-2324.pdf" target="_blank">23-24 Plan Highlights</a></li> <li><a href="/pdf/Bridgewater-Subscriber-Certificate-2425.pdf" target="_blank">Subscriber Certificate (Policy)</a></li> <li><a href="/pdf/Bridgewater-Pediatric-Dental-2425.pdf" target="_blank">Pediatric Dental (Policy) <span class="no-wrap">for members under 19</span></a></li> </ul> </li> <li class="expanded"> <h3>Blue Cross Blue Shield Info</h3> <ul> <li><a href="https://myblue.bluecrossma.com/" target="_blank">Member Central</a></li> <li><a href="http://www.ahealthyme.com/healthytimes/" target="_blank">Healthy Times</a></li> <li><a href="https://myblue.bluecrossma.com/tools-resources/find-care/nurse-phone-line" target="_blank">24-Hour Nurseline</a></li> <li><a href="/pdf/GlossaryMedicalTerms.pdf" target="_blank">Glossary of Insurance Terms</a></li> <li><a href="/pdf/BCBS_EstimateMedicalCosts-2014.pdf" target="_blank">Estimate Medical Costs</a></li> <li><a href="https://www.blue365deals.com/browse-all-deals" target="_blank">Blue 365</a></li> <li><a href="/pdf/FitnessBenefit.pdf" target="_blank">Fitness Benefit</a></li> <li><a href="/pdf/WeightLossBenefit.pdf?" target="_blank">Weight Loss Benefit</a></li> <li><a href="https://www.bluecrossma.org/myblue/your-health/mental-and-behavioral-health/mental-health-resource-center" target="_blank">Mental Health Resource Center</a></li> </ul> </li>  <li><a class="lightbox" data-fancybox-type="iframe" href="/custom/bcbs-find-provider.html" target="_blank">Provider Search</a> </li> <li><a href="/worldwide_coverage/BridgewaterSC.html">Worldwide Providers &<br/> Travel Assistance</a></li> <li class="expanded"><h3>Prescription Info</h3> <ul> <li><a class="lightbox" data-fancybox-type="iframe" href="/custom/bcbs-prescription-drug-search-2022-08-01.html" 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/member_lookup.cgi?group_id=212">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="/custom/MassHealth_Participants.html" target="popup:width=500,height=250,resizable=yes,scrollbars=yes,menubar=yes:MassHealthParticipants">Health Connector Participant Info</a> </li> <li><a href="/insurance_options/BridgewaterSC.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><strong><u>Please note,</u></strong> with the rising costs of healthcare, and increase in utilization of the Plan, <u>the following plan changes have been imposed for the 2024-2025 academic year </u>to help keep the insurance premium and the plan a viable option for all students.</p> <ul> <li>Deductible will be $500</li> <li>Out-of-pocket maximum will be $9,100</li> <li>In-network preventive care - deductible will not apply.</li> <li>In-network office visit copay will be $30 for primary and mental health visits and $65 for specialist visits (deductible will not apply in-network).</li> <li>Emergency room copay will be $200 (deductible will not apply).</li> <li>Ambulance services - new deductible will not apply.</li> <li>Diagnostic Tests & X-rays - In-network copays will be $50 for lab and $100 for x-ray (deductible does not apply). Out-of-network will be a 20% coinsurance.</li> <li>Imaging (CT/PET scans, MRIs will be a 20% coinsurance in-network/40% coinsurance out-of-network</li> <li>The 5-Tier Plan prescription drug copays: deductible does not apply <ul> <li>Tier 1: $20 copay (generic)</li> <li>Tier 2: $40 copay (preferred brand)</li> <li>Tier 3: $60 copay (non-preferred brand)</li> <li>Tier 4: 50% coinsurance (preferred specialty)</li> <li>Tier 5: 50% coinsurance (non-preferred specialty)</li> </ul> </li> </ul> <p>To look-up your prescription medication in the 5-Tier Plan, choose Prescription Info → Medication Look Up in the navigation menu on the left.</p> <p>We encourage students anticipating high out-of-pocket costs to compare other insurance options to the SHIP. The <a href="https://www.mahealthconnector.org/" target="_blank">Massachusetts Health Connector </a>offers information about their online insurance marketplace where you can compare and purchase insurance plans. You may be eligible for a Subsidized Health Plan (a low or no cost insurance program for qualifying uninsured adults).</p> <p/> <p class="text-center"><a href="/secure/enrollment.cgi?group_id=212" class="btn btn-primary btn-lg">I have read and acknowledge the above statements</a></p> </div> </div> <script> jQuery(function($){ $('#enrollment-form-link').fancybox({ maxWidth: 1000, maxHeight: 625, fitToView: false, width: '90%', height: '90%', autoSize: false, openEffect: 'none', closeEffect: 'none', title: '', modal: true }); }); </script></div> <div><div class="hidden"> <div id="benefits-coverage-changes" style="padding: 20px;"> <p><strong><u>Please note,</u></strong> with the rising costs of healthcare, and increase in utilization of the Plan, <u>the following plan changes have been imposed for the 2024-2025 academic year</u> to help keep the insurance premium and the plan a viable option for all students.</p> <ul> <li>Deductible will be $500</li> <li>Out-of-pocket maximum will be $9,100</li> <li>In-network preventive care - deductible will not apply.</li> <li>In-network office visit copay will be $30 for primary and mental health visits and $65 for specialist visits (deductible will not apply in-network).</li> <li>Emergency room copay will be $200 (deductible will not apply).</li> <li>Ambulance services - new deductible will not apply.</li> <li>Diagnostic Tests & X-rays - In-network copays will be $50 for lab and $100 for x-ray (deductible does not apply). Out-of-network will be a 20% coinsurance.</li> <li>Imaging (CT/PET scans, MRIs will be a 20% coinsurance in-network/40% coinsurance out-of-network</li> <li>The 5-Tier Plan prescription drug copays: deductible does not apply <ul> <li>Tier 1: $20 copay (generic)</li> <li>Tier 2: $40 copay (preferred brand)</li> <li>Tier 3: $60 copay (non-preferred brand)</li> <li>Tier 4: 50% coinsurance (preferred specialty)</li> <li>Tier 5: 50% coinsurance (non-preferred specialty)</li> </ul> </li> </ul> <p>To look-up your prescription medication in the 5-Tier Plan, choose Prescription Info → Medication Look Up in the navigation menu on the left.</p> <p>We encourage students anticipating high out-of-pocket costs to compare other insurance options to the SHIP. The <a href="https://www.mahealthconnector.org/" target="_blank">Massachusetts Health Connector</a> offers information about their online insurance marketplace where you can compare and purchase insurance plans. You may be eligible for a Subsidized Health Plan (a low or no cost insurance program for qualifying uninsured adults).</p> <p class="text-center"><a href="/pdf/MSU-Benefits-Coverage-2425.pdf" class="btn btn-primary btn-lg" target="_blank">Continue to the Summary of Benefits and Coverage</a></p> </div> </div> <script> jQuery(function($){ $('#benefits-coverage-link').fancybox({ maxWidth: 1000, maxHeight: 650, fitToView: false, width: '90%', height: '90%', autoSize: false, openEffect: 'none', closeEffect: 'none', title: '', modal: false }); }); </script></div> <div><div class="hidden"> <div id="benefits-summary-changes" style="padding: 20px;"> <p><strong><u>Please note,</u></strong> with the rising costs of healthcare, and increase in utilization of the Plan, <u>the following plan changes have been imposed for the 2024-2025 academic year</u> to help keep the insurance premium and the plan a viable option for all students.</p> <ul> <li>Deductible will be $500</li> <li>Out-of-pocket maximum will be $9,100</li> <li>In-network preventive care - deductible will not apply.</li> <li>In-network office visit copay will be $30 for primary and mental health visits and $65 for specialist visits (deductible will not apply in-network).</li> <li>Emergency room copay will be $200 (deductible will not apply).</li> <li>Ambulance services - new deductible will not apply.</li> <li>Diagnostic Tests & X-rays - In-network copays will be $50 for lab and $100 for x-ray (deductible does not apply). Out-of-network will be a 20% coinsurance.</li> <li>Imaging (CT/PET scans, MRIs will be a 20% coinsurance in-network/40% coinsurance out-of-network</li> <li>The 5-Tier Plan prescription drug copays: deductible does not apply <ul> <li>Tier 1: $20 copay (generic)</li> <li>Tier 2: $40 copay (preferred brand)</li> <li>Tier 3: $60 copay (non-preferred brand)</li> <li>Tier 4: 50% coinsurance (preferred specialty)</li> <li>Tier 5: 50% coinsurance (non-preferred specialty)</li> </ul> </li> </ul> <p>To look-up your prescription medication in the 5-Tier Plan, choose Prescription Info → Medication Look Up in the navigation menu on the left.</p> <p>We encourage students anticipating high out-of-pocket costs to compare other insurance options to the SHIP. The <a href="https://www.mahealthconnector.org/" target="_blank">Massachusetts Health Connector</a> offers information about their online insurance marketplace where you can compare and purchase insurance plans. You may be eligible for a Subsidized Health Plan (a low or no cost insurance program for qualifying uninsured adults).</p> <p class="text-center"><a href="/pdf/MSU-Benefits-Summary-2425.pdf" class="btn btn-primary btn-lg" target="_blank">Continue to the Plan Highlights</a></p> </div> </div> <script> jQuery(function($){ $('#benefits-summary-link').fancybox({ maxWidth: 1000, maxHeight: 650, fitToView: false, width: '90%', height: '90%', autoSize: false, openEffect: 'none', closeEffect: 'none', title: '', modal: false }); }); </script></div> </div> <div class="hidden"><div id="menu-contact-info-212" 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 833-251-1736.</p> <p>For <strong>specific benefit or claims questions</strong><br /> contact Blue Cross Blue Shield of MA 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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