Waiver Requirements

If you have active health insurance with benefits that meets all the criteria listed below, you may apply for a waiver of enrollment in the PNWU Student Health Insurance plan. You will need to have your current insurance ID card and information regarding your plan benefits to complete the process. You must submit a copy of your Health Insurance ID card's front and back with your request. Once you have submitted the required information, you will receive an email verifying if your waiver meets the PNWU waiver requirements. PNWU will not accept waivers past the required deadline.

Acceptable Waivers

All students MUST be covered by an ACA-compliant domestic health insurance plan for the entire academic year, including summer and holidays.

Plans that qualify to waive the PNWU student insurance plan are:

Parent's Employer Group
Spouse's Employer Group
Partner's Employer Group
COBRA - must be from an acceptable plan to waive of Parent, Spouse or Partner's Employer Group. Own Employer Group COBRA is not accepted as Own Employer Group coverage does not meet requirements to waive
Veteran/TRICARE Benefits
Washington Medicaid - Didactic Students only - must live in the state the entire academic year.
Medicare
Individual Plans - Marketplace - Deductible MUST NOT be more than $2,500 for individual and family (In many cases even if an individual deductible is listed, the family deductible must be met before benefits apply and is considered the deductible.) HSAC will verify individual plans quarterly. Maximum Out of Pocket Expense of no more than $8,700

Acceptable coverage to waive the PNWU-Sponsored Student Health Insurance Plan for all plans must include:

A provider network in the area of your PNWU campus for primary care, specialty, hospital, and diagnostic care. Students must have comprehensive coverage in the states where the student has designated rotations (HMO plans only qualified for the state you are residing).
Must be Metallic Tier Level Silver or higher
Must be ACA-Compliant
Unlimited Major Medical Coverage
Unlimited Lifetime Benefits
Unlimited Office Visits
Coverage for an annual exam
Prescription coverage
Mental health coverage
Wellness Benefit

Short-term health insurance policies, traveler's plans, own employer group plans, or plans originating outside the United States will not be accepted as part of the Waiver process.

Coverage must be in force for the entire school term.

Please note - you must have active coverage that meets all requirements set forth by PNWU by the waiver deadline. There are no exceptions to this policy or waiver deadline extensions.

For the 2024-2025 Spring Semester, if an acceptable waiver is not received by the waiver deadline of 01/15/2025 for continuing students and 07/31/2024 for incoming students, PNWU will finalize your enrollment in the student health insurance plan. Your student account will automatically be assessed the applicable 2024-2025 Spring Semester premium. You will no longer be eligible for a refund once your enrollment has been processed.

HSAC will periodically verify health insurance plans approved during the waiver process to ensure students comply with the University's health insurance coverage requirements.

All full-time students are automatically assessed for half of the annual student health insurance premium upon registration for the Fall Semester. This fee is reversed only if you submit proof of health insurance coverage that meets the University's coverage requirements. When you fail to submit proof of alternative health insurance coverage by the deadline for your program/class year, your student health insurance plan enrollment is finalized. You are no longer eligible for a refund of the first half of the premium. You will automatically be assessed the second half of the premium upon registration for the spring term.

Students in Clinical Rotations and Courses -

The following disclaimer applies to any student currently waived with Washington Medicaid who is leaving the state of Washington temporarily for Clinical Rotations or Courses -

“I understand that if, based on my imminent return to WA, I choose to retain WA Medicaid while out of the state for clinical experiences, I most likely will be covered only for life-threatening emergencies while outside WA.

Further, I understand that I will be responsible for any expenses incurred due to receiving medical care not covered by WA Medicaid when I am out of state.”

Periodic Waiver Verifications

If your waiver is approved, it is still subject to periodic verification throughout the academic year to ensure that your submitted plan is still active and meets the University's health insurance coverage requirements. It is incumbent on the student to ensure their plan remains active and in compliance with the University's health insurance requirements throughout the current academic year, including summer and holidays.

If your plan is found to be inactive or out of compliance, the University reserves the right to enroll a student in the student health insurance plan from the start of the period of non-compliance (even if your termination date was in the past) through the end of the current academic year. If your plan is found out of compliance, you will receive an e-mail notification from HSAC, and you will have 14 calendar days to respond. If you have not responded within 14 calendar days, the University will proceed with enrollment in the student health insurance plan, assess your student account for the applicable premium charges, and notify your program of your non-compliance with the University's health insurance requirements.

Involuntary Loss of Coverage/Age-Outs

If you originally waived out of the student health insurance plan but find that you need health insurance coverage later in the year due to an involuntary loss of coverage or if you have aged out of your parent's insurance plan, you can also enroll via the Health Sciences Assurance Consulting website. Students enrolling after the initial enrollment period due to an involuntary loss of coverage will be assessed a prorated portion of the insurance premium based on their enrollment dates. Students have 14 calendar days after an involuntary loss of coverage to enroll in the student health insurance plan or submit updated proof of coverage. Proof of coverage must show that the new coverage is in effect as of the termination date of previous coverage. No gaps in coverage are permitted.

Students must maintain continuous enrollment in health insurance. If you are submitting new proof of coverage, it must begin at the same time as your previous coverage termination. You are not eligible to waive if you have any coverage gap.

Once you have submitted the required information, you will receive an email verifying if your waiver meets the PNWU requirements. If your coverage does not meet requirements, you will be provided with details in an email.

Please be aware that you will be automatically enrolled in the health insurance plan, and the health insurance charge will remain on your account if a waiver request is not completed and approved. PNWU will not accept waiver requests after your deadline.

If you are currently insured by another plan, please take the time to compare your benefits and cost to the 2024-2025 PNWU student health insurance plan. The PNWU health plan offers very comprehensive benefits, and the cost for the group coverage may be lower than your current plan. Remember, you will need an involuntary loss of coverage to enroll in the student health plan after the annual open enrollment period has ended once you waive. If you turn 26 during the academic year, it is a qualifying life event. Therefore, you will be eligible to enroll in the PNWU student health insurance plan. It is important to note that voluntary termination does not make you eligible for enrollment after the annual enrollment period has ended.

Insurance Fraud Warning: Any person who knowingly presents a false or fraudulent claim for payment of a loss of benefits or knowingly presents false information in an insurance application is guilty of a crime and may be subject to fines and confinement in prison.

By submitting your waiver request, you acknowledge that you have read the Waiver Requirements and PNWU Insurance Policy, agree to abide by all policy terms and understand that HSAC will verify your insurance coverage.

Waiver Form