Samuel Merritt University requires all students to obtain and maintain continuous coverage in a domestic medical insurance plan that is compliant with the Affordable Care Act (ACA). The minimum level of coverage for waiving enrollment in the student health insurance plan includes an ACA-compliant level medical plan, urgent and non-urgent care, mental health benefits, and prescription coverage. Each student is required to maintain continuous medical health insurance coverage until they are no longer an active student, i.e. graduate, withdraw, etc.
If a student has acceptable health insurance coverage effective on or before their first day of orientation an online waiver needs to be submitted along with copies of the front and back of their insurance ID card to waive enrollment in the Samuel Merritt University Sponsored Student Health Insurance Plan.
If a student does not have acceptable health insurance coverage effective on or before their first day of orientation an enrollment request for the SMU Enhanced or Basic medical plan must be submitted for coverage effective their first day of orientation. Students who do not submit a waiver or enrollment request will be enrolled in and charged for the SMU Basic medical plan with coverage effective their first day of orientation.
The annual open enrollment period occurs in August. Requests may be submitted in July or August but no later than August 31st and changes will be effective August 1st. Open enrollment is when requests to change from one SMU medical plan to another need to be submitted as well as requests to add or terminate enrollment in SMU’s dental and vision plans. The SMU dental and vision plans are voluntary plans and do not allow for mid-year termination.
Description of Student Health Insurance Plan
The SMU Sponsored Health Insurance Plan is a Preferred Provider Plan (PPO) underwritten by Anthem Blue Cross Blue Shield. The plan has been designed specifically for SMU students and their dependents (spouse, domestic partner, and/or children) with an emphasis on wellness. The plan is designed to provide full coverage for medical care including annual routine physicals, well child care and immunizations.
The SMU student health plan offers two options, Enhanced and Basic. Both plans offer a full comprehensive plan of benefits but the Enhanced plan will provide coverage with a lower annual deductible, lower out-of-pocket maximum, coinsurance and copays. If enrolling in the Basic plan you will have access to the same benefits as the Enhanced plan but with a higher annual deductible, higher out-of-pocket maximum, coinsurance and copays.
Health Insurance Plan - Summary of Plan Benefits and Costs 2016-17
(policy plan year August 1st - July 31st)
All new incoming students will be charged for student only coverage in the SMU Basic Medical Plan prior to the start of the semester. The charge to the student's account will be removed if an approved waiver is granted or adjusted if enrollment in the Enhanced Medical plan is elected.
|Plan Rates 2016-2017||Enhanced Annual*||Basic Annual*|
|Student + Spouse||$11,413.80||$8,458.92|
|Student + Child(ren)||$11,413.80||$8,458.92|
*Rates represent Medical and OnCall repatriation coverage for the full policy year. The premium charge for incoming students is prorated based on the date of enrollment.
For a detailed summary of benefits please click on the following attachments.
The SMU health plan is a PPO plan which allows for benefits when utilizing either in network or out of network providers. To maximize your benefits you may access Anthem Blue Cross to locate in network participating providers. If you do not have your ID number available you will identify your plan type as Blue Cross PPO (Prudent Buyer) - Large Group.
Dental and Vision Plan - Anthem Plan Brochure and Cost
(policy plan year August 1st - July 31st)
The SMU sponsored health plan offers voluntary Dental and Vision benefits. The plan is underwritten by Anthem BCBS and provides a variety of benefits. The dental and vision plan enrollment is processed as one plan. If you are enrolling in one you will automatically be enrolled for both portions of coverage. The dental and vision plan is annual and does not allow for mid-year terminations. Changes to dental and vision coverage need to be requested during the annual open enrollment period which occurs in August (requests need to be submitted in July or August but no later than August 31st for changes that are effective August 1st).
|Plan Rates 2016-2017||Annual*|
|Student + Spouse (DP)||$390.00|
|Student + Child||
|Student + Children||$597.00|
*Rates represent Dental and Vision coverage for the full policy year. The premium charge for incoming students is prorated based on the date of enrollment.
For additional information regarding the Anthem Dental plan please click on the following attachment.
For additional information regarding the Anthem Vision plan please click on the following attachment.
If you are an incoming student and have acceptable health insurance coverage you may submit your waiver request by clicking the "Waiver" tab at the top of this page. Once your waiver is processed you will receive a confirmation email from HSAC and if your waiver is approved SMU will be notified to remove the health insurance charges from your student account.
Waiver requests may be submitted throughout the year.
If you have an approved waiver on file and your insurance information changes you need to submit an updated waiver within 30 days of the change to confirm acceptable, continuous coverage.
If you have an approved waiver on file and your insurance coverage terminates, within 30 days of the termination date, you need to submit an updated waiver with proof of acceptable, continuous coverage or submit a request to enroll in one of the SMU student medical plans.
If you are enrolled in SMU's Enhanced or Basic medical plan and you obtain other health insurance coverage, when your new coverage is active submit a waiver request within 30 days of the effective date of your new coverage. Once your new coverage is verified and your waiver is approved the termination date of your enrollment in the SMU medical plan will be determined by the effective date of your new coverage, the date you last utilized the SMU medical and/or prescription plan benefits, and the date you submitted the waiver request. Terminations are processed effective the last day of the month and retroactive adjustments are limited to a maximum of one month so it is important to submit the waiver as soon as your new coverage is active but no later than 30 days after the effective date. **Do not wait for your new insurance ID card to submit your waiver. If your coverage is active and you have your new insurance information including your subscriber ID number go ahead and submit the waiver and HSAC will attempt to verify coverage using the information provided. If you are applying for new coverage, it is recommended to request an effective date of the 1st of the month to avoid dual coverage and premiums. If your waiver is approved and enrollment in the SMU medical plan is terminated please allow 3 to 5 business days for your student account to be adjusted.
Please note the SMU dental and vision plans are annual and do not allow for mid-year termination. If you wish to cancel the dental/vision coverage requests may be submitted in July or August but no later than August 31st for the open enrollment period and coverage will be terminated as of July 31st which is the end of the policy year.
If you are having difficulty with the online waiver process please contact HSAC at 888-978-8355 or email@example.com for assistance.
Enrollment requests may be submitted by clicking the "Enroll" tab at the top of this page. All students who do not submit an acceptable waiver or enrollment request are automatically enrolled in and charged for the SMU Basic Medical Plan.
Incoming students are eligible to enroll in the SMU student health insurance with coverage effective their first day of orientation.
Continuing students are eligible to enroll during the annual open enrollment period in August (requests may be submitted in July or August but no later than August 31st for coverage effective August 1st) or if they have a qualifying event, i.e. an involuntary loss of group health insurance coverage, during the year. Enrollment requests due to qualifying events need to be submitted no later than 30 days after the termination date of coverage and proof of loss (this is usually a document from an HR department or insurance company confirming the date benefits terminated) needs to be provided. The effective date of enrollment will coincide with the termination date to ensure continuous coverage.
- Students enrolling for coverage in the SMU - Sponsored Student Health Insurance Plan may also enroll their eligible dependents. An eligible dependent is a spouse (or domestic partner) and/or any child(ren) under the age of 26. Students must also enroll their dependents for coverage within 30 days of their initial eligibility.
- If a student's dependents have group health insurance coverage that ends during the academic year, the dependents may be enrolled in the SMU - Sponsored Student Health Insurance Plan provided the request for enrollment is submitted within 30 days of the date of loss of prior coverage and proof of loss documentation is provided.
- Additionally, if a student acquires dependents during the academic year as a result of marriage, birth, adoption, or placement for adoption, they may enroll their new dependents provided the request for enrollment is made within 30 days after the marriage, birth, adoption, or placement for adoption.
If you are having difficulty with the online enrollment process or have questions regarding enrollment requests at times other than open enrollment please contact HSAC at 888-978-8355 or firstname.lastname@example.org for assistance.
Enrollment in the SMU Student Health Insurance Plan for November or December graduates will terminate effective January 31st unless the student elects to continue coverage and submits payment to SMU. Coverage may be continued through the remainder of the current policy year with a termination date of July 31st.
Enrollment in the SMU Student Health Insurance Plan for April, May or June graduates will terminate effective July 31st, the end of the current policy year.
Enrollment in the SMU Student Health Insurance Plan for August graduates will terminate effective August 31st unless the student elects to continue coverage and submits payment to SMU. Coverage may be continued through the remainder of the current policy year with a termination date of July 31st.
If a graduate obtains other acceptable health insurance coverage they may submit an online waiver request. Once coverage is verified, enrollment in the SMU Enhanced or Basic Medical Plan will be terminated.
Questions and Contact Information
The Servicing Administrator for the SMU - Sponsored Student Health Insurance Plan is HSA Consulting, Inc. (HSAC).
- For questions related to waiver requests, eligibility, enrollment, benefits or claims please contact: HSAC at (888) 978-8355, and identify yourself as a SMU student.
- For specific questions related to waiver denials please contact Dee Witte with HSAC at (888) 978-8355 or email@example.com