General Information

All Samuel Merritt University students are required to have acceptable health insurance coverage in effect by their program’s orientation date.  If a student has acceptable health insurance coverage (must provide benefits for urgent and non-urgent medical care in the SMU area) and would like to waive enrollment in the Samuel Merritt University Sponsored Student Health Insurance Plan an online waiver, along with copies of the front and back of their current insurance ID card, needs to be submitted.  If a student does not have health insurance coverage effective on or before the orientation date an enrollment request for the SMU Enhanced or Basic medical plan must be submitted for coverage effective the orientation date.  Students who do not submit a waiver or enrollment request will be enrolled in and charged for the SMU Enhanced medical plan with coverage effective as of their program's orientation date.

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
(policy plan year August 1st - July 31st)

All new incoming students will be charged for student only coverage in the SMU Enhanced 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 if enrollment in the Basic plan is elected.

Plan Rates 2014-2015 Enhanced Annual* Basic Annual*
Student Only $4,476.00 $3,312.00
Student + Spouse $9,828.00 $7,284.00
Student + Child(ren) $9,828.00 $7,284.00
Family $13,608.00 $10,080.00

*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.

2014-15 SMU Enhanced Medical Plan Summary

2014-15 SMU Basic Medical Plan Summary

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 refer to the following links to locate in network participating providers. For a provider or facility search you may access Anthem Blue Cross for 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.

For a list of participating Urgent Care facilities in the Oakland area please click on the following attachment.

BCBS Urgent Care Facilities

For a list of participating Hospitals in the Oakland area please click on the following attachment.

BCBS Hospitals

For a list of participating Laboratories in the Oakland area please click on the following attachment.

BCBS Laboratories

For a list of participating x-ray/radiology facilities in the Oakland area please click on the following attachment.

BCBS X-ray/radiology

Please be aware that the above lists represent a portion of the BCBS network within a 10 mile radius of Oakland and other providers are available. The network is subject to change therefore please refer to the Anthem BCBS website or member services to confirm provider participation.

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 no later than August 31st for changes that are effective August 1st).

Plan Rates 2014-2015 Annual*
Student Only $261.24
Student + Spouse (DP) $476.40
Student + Child

$459.60

Family $881.52

*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.

2014-15 Dental Plan Summary of Benefits

For additional information regarding the Anthem Vision plan please click on the following attachment.

2014-15 Vision Plan Summary of Benefits

 

Waiver Process

You may submit your waiver request by clicking the "Waiver" tab at the top of this page. Waiver requests may be submitted throughout the year if you obtain other health insurance coverage.  Once your coverage is verified as active and acceptable (must provide benefits for urgent and non-urgent medical care in the SMU area) your enrollment in the SMU Enhanced or Basic Medical Plan will be terminated.  Terminations are processed effective the last day of the month.  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.

Students who lose or change coverage while an active SMU student are required to submit an updated waiver request within 30 days of the change to confirm acceptable, continuous coverage.

If you are having difficulty with the online waiver process please contact HSAC at 888-978-8355 or smu@hsac.com for assistance.

 

Enrollment Process

All students who do not submit an acceptable waiver or enrollment request are automatically enrolled in and charged for the SMU Enhanced Medical Plan.

You may submit your enrollment request by clicking the "Enroll" tab at the top of this page. If you are having difficulty with the online enrollment process please contact HSAC at 888-978-8355 or smu@hsac.com for assistance.

Students who lose coverage throughout the year and do not have other acceptable insurance coverage are required to submit an enrollment request, with supporting documentation regarding proof of loss, within 30 days of the date of loss of prior coverage.  You may submit your request by clicking the "Enroll" tab at the top of this page.

Dependent Eligibility

  • 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 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.
  • 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.

For enrollment requests at times other then open enrollment please contact HSAC for assistance at (888) 978-8355.

GRADUATES

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 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 policy year.

Enrollment in the SMU Student Health Insurance Plan for August graduates will terminate effective August 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 Trish Ivey with HSAC at (888) 978-8355 or smu@hsac.com