2014–2015 Health Insurance Orientation
Student Health and Counseling Services
Presenters:
Slide 2 of 36
Karla Abrantes
Coordinator, Student Health & Counseling
• Immunization
•Student Health Insurance Plan
Fred B. Hollick, Jr.
Vice President of National Sales & Marketing
Student Resources – United Healthcare
Services offered by Student Health and Counseling
Slide 3 of 36
1. Licensed therapists and a part-time psychiatrist who
provide short-term psychotherapy for a variety of mental
health issues.
2. A registered nurse is available for health education and
suggestions for additional health resources (e.g. locating
medical services off campus, understanding the different
types of health care professionals, questions on illnesses,
women’s health, men’s health, sexual health, etc.).
3. General assistance with the student injury and sickness
insurance plan.
Appointments are necessary for all visits. Students can
call or visit the office to make an appointment.
Services offered by Student Health and Counseling
Slide 4 of 36
IMPORTANT: • Services provided by our office are free and confidential.
• Students can take advantage of our services whether they are
enrolled in the SVA student insurance plan, or maintain insurance
coverage on their own.
• Medical services are NOT available on-site:
• Students needing medical attention should seek assistance
from a doctor or hospital.
• Students do not need to visit the office for referrals before
visiting a doctor or hospital.
• For emergencies, please dial 911 and contact Security.
SVA-Sponsored Health Insurance
Slide 5 of 36
• Students are automatically enrolled in the 2014-2015 UnitedHealthcare StudentResources Injury and Sickness Insurance Plan
• Dental or Vision coverage not available except for pediatric dental and vision (students 18 yrs & younger). Please see Brochure for details at, www.sva.edu/uhp
• $1,035 per semester; Deductible $100; Physician Visit Copay $10
• Fall Coverage - August 25, 2014 until January 7, 2015
• Spring Coverage - January 8, 2015 until August 24, 2015
• Please review the Insurance Tab on sva.edu/health for important general information about the insurance plan.
• Refer to the United Healthcare Getting Started 2014-15 and the Summary PDF’s at www.sva.edu/health for more information.
Waiving the Health Insurance Fee
Slide 6 of 36
• Students are automatically enrolled in the student
insurance plan each semester. However,
students who already have comparable
health insurance coverage coming into SVA,
can waive the per semester Health Insurance
Fee of $1,035, and be removed from enrollment.
• An online waiver form must be completed by
the deadline, October 2, 2014, and can be
accessed at www.sva.edu/uhp.
> The waiver form must be completed each year, by each fall
semester. It can also be completed in the spring should a
student miss the fall deadline.
> Bookmark www.sva.edu/health for updates each semester.
Waiver Form Deadlines
Slide 7 of 36
• The Fall Waiver Form deadline is
October 2, 2014.
> Completing the waiver form will remove
you from the Insurance Plan and remove
the Health Insurance Fee for both Fall 14
and Spring 15 semesters.
• The Spring Waiver Form deadline is
February 12, 2015.
> Should you miss the fall waiver deadline, or now have
your own insurance coverage for the spring, you can
complete the spring waiver form by this date.
Getting Started with UnitedHealthcare StudentResources
Slide 8 of 36
• August 2014: First insurance email
sent to students’ SVA email account.
• Email Subject: IMPORTANT You’re Enrollment in United
Healthcare Fall 2014:
• Reminder that you’re enrolled in the
• UnitedHealthcare StudentResources’ administered plan.
• Contains information on creating an online account,
printing out your insurance ID card, reviewing the benefits,
and finding local doctors.
• Reminder to complete online waiver form by the deadline.
If you did not receive this email, please visit us at
www.sva.edu/health and click on the United Healthcare
Getting Started 2014-15 pdf.
Going Off Campus for Health Care
Slide 9 of 36
Since SVA does not provide medical services on campus, you must visit a doctor
off-campus. You have several choices:
• Private Doctors and/or Specialists treat non-emergency patients by appointment
during regular office hours, typically 9:00AM until 5:00PM. Some of these doctors
may have weekend hours, but can vary.
• Minor Emergency Clinics or Urgent Care do not require appointments and are
usually open on weekends and holidays. You can simply walk in for medical
services. (For example, City MD, NY Doctors Urgent Care, Beth Israel, etc. These
locations can be found online at sva.edu/health under the Downloads section.)
• Hospital Emergency Rooms provide serious emergency care. Go to the nearest,
hospital by ambulance if necessary. Hospital emergency rooms are designed to
treat life-threatening ailments. This is typically the most expensive place to
receive care.
If you need to use a medical facility but are uncomfortable with your English skills,
ask a friend who speaks English to go with you. Proper communication is very
important!
Find a Doctor
Slide 10 of 36
www.sva.edu/health www.sva.edu/uhp
www.sva.edu/uhp for Plan Information
Slide 11 of 36
StudentResources
School of Visual Arts 2014–2015 Student Injury and Sickness Insurance Plan
Slide 12 of 36
Points to Consider Prior to Waiving
Slide 13 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
• The SVA Student Injury & Sickness Insurance Plan
includes coverage for preventive care services, has a low
up-front deductible, and a prescription medication plan.
• If your current coverage is through an HMO or PPO, local
services in New York City may be limited or may be
charged to you at a higher, non-preferred rate.
• Your current insurance plan may only cover urgent or
emergency care outside of their network.
• Your current plan may not include coverage worldwide.
The SVA Student Plan provides worldwide coverage and
includes Medical Evacuation and Repatriation.
Rates
Slide 14 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
Annual 8/25/14–8/24/15
2nd Semi-Annual 1/8/15–8/24/15
Student $2,070 $1,035
This plan is underwritten by UnitedHealthcare Insurance Company of New York and is based on Policy #2014-885-1. For a full description of coverage, including costs, benefits, exclusions, any reductions or limitations and terms under which the policy may be continued in force, log on to www.sva.edu/uhp.
Plan/Benefit Highlights
Slide 15 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
• Unlimited Maximum Per Insured Person, Per Policy Year
for Covered Medical Expenses.
• $100 Deductible Per Insured Person, Per Policy Year.
What’s a deductible? A “deductible” is the amount of money you must
pay towards covered medical expenses before the
insurance company pays.
Plan/Benefit Highlights
Slide 16 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
Covered Medical Expenses for
Preferred Providers are
payable at 90% of Preferred
Allowance and Out-of-Network
benefits are payable at 60% of
Usual and Customary charges
(all benefits are subject to
satisfaction of the deductible,
specific benefit limitations,
maximums, and copays as
described in the policy).
Plan/Benefit Highlights
Slide 17 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
Benefits Preferred Providers Out-of-Network
Hospitalization 90% 60%
Surgery 90% 60%
Outpatient Services 90% 60%
Emergency Room 90% 90%
Physician’s Office Visit $10 copay, 100% $10 deductible, 70%
Preventive Care and
Immunizations 100%, no cost sharing No Coverage
Dental Injury (to sound,
natural teeth only) $10 copay, 100% $10 deductible, 100%
Plan/Benefit Highlights
Slide 18 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
Benefits Preferred Providers Out-of-Network
Inpatient Mental Health 90% 60%
Outpatient Mental Health $10 copay, 100% $10 deductible, 70%
Inpatient Substance
Abuse 90% 60%
Outpatient Substance
Abuse $10 copay, 100% $10 deductible, 70%
Ambulance Expense 100% 100%
Plan/Benefit Highlights
Slide 19 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
• Prescription Drug Benefits: $10 copay for Tier 1;
$20 copay for Tier 2; up to a 31-day supply per
prescription.
• Prescriptions must be filled at a UnitedHealthcare
Pharmacy. Mail order at 2.5 times the
retail copay, up to a 90-day supply.
Plan/Benefit Highlights
Slide 20 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
• The Preferred
Provider Network for
this plan is
UnitedHealthcare
Options PPO.
Preferred Providers
can be found using
the following link:
www.uhcsr.com/sva.
Region Providers Hospitals
Central 221,305 2,133
Northeast 198,494 986
Southeast 136,104 1,243
West 139,344 865
Leased 43,473 373
Total 738,720 5,600
Plan/Benefit Highlights
Slide 21 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
FrontierMEDEX: Global Emergency Services
Domestic students are covered
when they’re 100 miles or more
away from their campus or home
address. International students
are covered worldwide except in
their home country.
Plan/Benefit Highlights
Slide 22 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
UnitedHealth Allies®
• Included with every policy, the UnitedHealth
Allies discount program typically saves
members 5–50% on many health and
wellness products and services.
• Members save on dental and vision care,
fitness club memberships, weight
management programs, smoking cessation,
massage therapy, and much more.
The UnitedHealth Allies Discount Program is administered by HealthAllies, Inc., a discount
medical plan organization. This discount program is not a qualified health plan under the
Affordable Care Act. UnitedHealth Allies discount plan is NOT insurance.
Plan/Benefit Highlights
Slide 23 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
Collegiate Assistance Program (CAP)
• Nurseline Services Experienced registered nurses can help
with nearly any health or medical concern, 24/7.
Call Toll-Free: 877-643-5130.
• Telephonic/Online Counseling Students facing stressful or
emotional issues have 24/7 access to prompt counseling
services.
• Innovative Web-based Services Our website for students,
www.liveandworkwell.com, offers a wealth of information on
a full range of topics.
• Legal and Financial Services Non-clinical issues such as
mounting credit card debt, divorce, child custody matters,
and shelter from abusive relationships.
Plan/Benefit Highlights
Slide 24 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
My Account
With My Account, available through www.uhcsr.com/sva or
www.sva.edu/uhp, insured students can securely:
• Review plan coverage details online
• Print an ID card and/or request a replacement ID card
• Check claim status and review EOB
(Explanation of Benefits)
• Find a Preferred Provider
• Update personal information
• Contact UHCSR with a question/comment
• Access helpful resources and forms
Plan/Benefit Highlights
Slide 25 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
Create your secure
My Account page: From www.sva.edu/uhp, click
on “Login to My Account”, then
“Create Your Online Account.”
Type in your first name, last
name, date of birth (as shown)
and for email: your SVA email
account. Click CONTINUE
Plan/Benefit Highlights
Slide 26 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
UHCSR Mobile App
With the free UHCSR Mobile App, available at GooglePlay
and Apple’s AppStore, you’ll have access to the most
popular self-service features like:
• Viewing and sharing your ID card.
You can even email or fax it to your
provider.
• Viewing claims received within
the prior 60 days.
• Searching for a Preferred Provider.
• Accessing your custom My
Account page.
Plan/Benefit Highlights
Slide 27 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
Understanding your ID Card
Member ID# This is the Member
Identification number your
provider will need to confirm
your benefits.
Group Name This is the Group Identifier
your provider will need to
confirm your benefits.
Plan Name This is the plan name you
need to provide to physicians
or when online.
Plan/Benefit Highlights
Slide 28 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
Health Insurance 101
Located at www.uhcsr.com, Health Insurance 101 defines
and clarifies the often confusing world of health insurance
and its jargon—from an overview of health care to a
glossary of common terms available in English, French,
Spanish, Chinese, Korean, and Arabic.
Plan/Benefit Highlights
Slide 29 of 36 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group
Submitting a Medical Claim
• Providers will typically file claims on your behalf.
• You don’t need a company claim form to file a claim.
• If you receive services from a provider who would like
payment upfront, simply send (within 90 days of sickness
or injury) all medical and hospital bills,
along with the patient’s name, address,
social security number, or school ID
number to this address.
• If you prefer to fax your claim, the
number is 469-229-5510.
Send claims to:
UnitedHealthcare
StudentResources
PO Box 809025
Dallas, TX
75380-9025
Submitting a Prescription Claim
• Visit www.uhcsr.com and click on Helpful Resources and
Forms.
• Under FORMS, Click on the Prescription Reimbursement
Request Form.
• Keep all receipts and send with request
form.
• Make note of the different claim address
Plan/Benefit Highlights
Send claims to:
OptumRx Claims
Department, P.O.
Box 29044, Hot
Springs AR 71903
Getting Started with UnitedHealthcare StudentResources
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Use your account to
review benefits statements
AND add
to your SVA email contacts
to receive important emails
from United Healthcare
Print out your insurance ID
card immediately and carry
it with you at ALL TIMES
OR
Download the UHCSR app
to your iPhone or Android
phone
Familiarize yourself with
how to find health care
providers (doctors),
Medical & Mental Health
Familiarize yourself
with the benefits and
discount programs
Take time to review the information
on www.sva.edu/uhp,
including the Brochure
Create an Online Account (through your
secure My Account page) by
going to www.sva.edu/uhp
Review “United Healthcare Getting Started
2014-15” PDF
www.sva.edu/health
Quiz Time
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• How do you obtain your Insurance ID card?
• Can you see a doctor who is out of the network?
• Where can you find information on insurance benefits and/or
creating an online account?
• Where can you find the UnitedHealthcare pdf’s containing
information on getting started with the student insurance?
• What are some ways you can locate a doctor?
• If you’re feeling sick, what are some of the steps you should take?
• What type of services can SH&CS offer students?
Quiz Time
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• What is your co-pay cost?
• Do you need to contact SH&CS first before going to the doctor or
hospital?
• How will you be able to receive your insurance statements and
view the information concerning your account?
• When should you carry your Insurance ID Card?
• What email account should you be checking for notifications from
Student Health Services and United Healthcare?
Questions?
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UnitedHealthcare StudentResources
Phone: 800-767-0700
Email: [email protected]
Student Health & Counseling Services
Phone: 212-592-2246
Email: [email protected]
www.sva.edu/health
www.sva.edu/uhp
Fall Hours: Monday–Friday, 9:00AM–5:00PM