sva united healthcare orientation presentation

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


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


• 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.



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).



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%



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%



• 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.



• 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



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.



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.



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.



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



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



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.



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.



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.



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


Send claims to:

OptumRx Claims

Department, P.O.

Box 29044, Hot

Springs AR 71903

http://www.uhcsr.com/

[email protected]

Getting Started with UnitedHealthcare StudentResources

Slide 31 of 36

Use your account to

review benefits statements

AND add

[email protected]

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

Slide 32 of 36

• 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

Slide 33 of 36

• 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?

Slide 34 of 36

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

sva united healthcare orientation presentation

Documents

semester health insurance

health education

sexual health

sva student insurance

insurance tab

additional health resources

sickness insurance plan

student injury