WesternU Student Health Insurance

Student Health Insurance Requirements

Mandatory Coverage

Maintaining comprehensive health insurance coverage is mandatory for all full-time WesternU students, and all students MUST be covered by an ACA compliant domestic health insurance plan for the entire academic year, including summer and holidays. All full-time WesternU students are required to enroll in the Student Health Insurance Plan unless an acceptable Waiver is provided by the designated deadline.

Part-time WesternU students, those enrolled in programs where the entire curriculum is delivered online and students only enrolled in thesis/dissertation continuous registration courses are exempt from the University’s comprehensive health insurance requirement. However, all WesternU students may enroll in the student health insurance plan, regardless of their exemption status.

Please note, students in programs that are currently being delivered through distance education as a direct result of COVID-19 do not qualify for the student health insurance exemption.

However, all WesternU students may enroll in the student health insurance plan, regardless of their exemption status.

There are many insurance options available in the marketplace today. We encourage you to research your health insurance options thoroughly prior to making a final decision. For those of you unfamiliar with insurance terminology, HealthCare.gov provides a glossary of health insurance terms that may be helpful as you review and compare your insurance options.

Automatic Fee Assessment

All full-time WesternU students will automatically be assessed the fall 2020 premium for the student health insurance plan during fall 2020 registration. The fall 2020 premium charge will only be reversed upon receipt of an acceptable waiver by the posted waiver deadline.

If an acceptable waiver is not received by the posted waiver deadline, your enrollment in the student health insurance plan will be finalized, you will no longer be eligible for a refund of the fall 2020 premium, and your student account will automatically be assessed the applicable spring 2021 premium during registration for the spring 2021 term.

2020/2021 Academic Year

If you are a continuing student currently enrolled in the WesternU Student Insurance plan you do not need to submit an enrollment request for 2020/2021.  For students currently enrolled in the 2019/2020 Policy year, your enrollment will automatically continue to the 2020/2021 student plan unless you submit a waiver by your program's deadline. The 2020/2021 WesternU Student Insurance Plan is pending approval from the State of California.  You will be notified as soon as we have received approval. The 2020/2021 Premium is listed however it is subject to change until final approval is received.

If you are currently waived from the WesternU student plan you do not need to resubmit your waiver.  If we are unable to verify the coverage we have on file for you, you will be contacted via email from HSA Consulting, Inc. (HSAC), the WesternU Insurance Plan Administrator.

Enrolling in the Student Health Insurance Plan

If you wish to enroll in the student health insurance plan for the 2020/2021 academic year, you must submit your enrollment via the Health Sciences Assurance Consulting (HSAC) website. The earlier you submit your enrollment, the sooner you will receive your plan materials (brochure, ID card). Students enrolling after the plan begins will have their coverage backdated to the start of the plan unless they have experienced an involuntary loss of coverage.

Student Health Insurance Plan Information

The student health insurance plan for the 2020/2021 academic year is offered through Aetna Student Health and administered by Health Sciences Assurance Consulting (HSAC). Plan details include:

 Deductible  $250
 Co-Insurance  80% – Preferred Provider Organization (PPO), 60% – Non-PPO
 Out of Pocket Maximum (Individual)  $6,350 (PPO), $10,000 (Non-PPO)
 Out of Pocket Maximum (Family)  $12,700 (PPO), $20,000 (Non-PPO)
 Office Visit  $20 Copayment, 100% (PPO), 60% (Non-PPO)
 Urgent Care Visit  $20 Copayment, 100% (PPO), 60% (Non-PPO)
 Emergency Room Visit  $200 Copayment (Waived if Admitted)
 Prescription Drugs  $15/$25/$45

 

 

 

 

 

 

 

2020/2021 Aetna Student Health Insurance Plan Summary of Benefits

Student Health Insurance Plan Premiums 2020/2021 - effective 08/01/2020 - 07/31/2021*

Student health insurance charges for the 2020/2021 academic year are listed below but are subject to change pending final state approval:

Program Coverage Start Date Coverage End Date Annual Premium Fall Semester Spring Semester

MSMS 2021

06/01/2020 07/31/2021 $4,104.44 $2,052.22

$2,052.22

ISAC 2024 - DO, DONW, DPM  06/01/2020 07/31/2021 $4,104.44 $2,052.22 $2,052.22
DPM-A S 2022 06/01/2020 07/31/2021 $4,104.44 $2,052.22 $2,052.22
IPBP 2022 07/01/2020 07/31/2021 $3,803.24 $1,901.62 $1,901.62
CGN (Incoming Students) 07/27/2020 07/31/2021 $3,542.40 $1,771.10 $1,771.10
All Other Student Groups 08/01/2020 07/31/2021 $3,492.00 $1,746.00 $1,746.00
MSBS, MSHS, MSPS, Spring Starts* 01/01/2021 07/31/2021 $2,028.84   $2,028.84
DMD-IDP 2023 03/01/2021 07/31/2021 $1,464.21   $1,464.21

* The WesternU Student Plan is pending approval from the State of California, premium is subject to change.

For additional information on the benefits offered under the student health insurance plan, please visit the Documents tab on this website. 

*Available only to students who begin their enrollment at WesternU during the Fall 2020 term.

All insurance coverage is subject to applicable state form and rate filing approval and, once approved to the terms of the Master Policy.  We have not yet received approval from the state insurance department for the 2020/2021 benefits and rates described in this document.  As part of the approval process, the State may require us to make changes to the benefits and/or rates.  We will notify you if that happens.

The student health insurance plan is sold as an academic year plan; however, the premium is split into two equal payments. The first payment is assessed during fall 2020 registration, and the second payment is assessed during spring 2021 registration. Students who enroll in the student health insurance plan at the start of the academic year will remain enrolled for the entire academic year and will not be eligible to waive out of the plan during the spring term.

Students who are receiving financial aid may be eligible for a budget increase to cover the costs of the student health insurance plan premiums. For more information on eligibility and the process for increasing your budget, please contact the Office of Financial Aid at 909-469-5353 (Pomona campus) or 541-259-0360 (Lebanon campus). You can also e-mail the Office of Financial Aid at finaid@westernu.edu.

Students enrolling in the WesternU student insurance plan from 06/01/2020 – 07/31/2021 will be enrolled on the 19/20 policy year until 07/31/2020.  Your enrollment will continue on the 20/21 Policy year effective 08/01/2020.  Deductibles and Out-of Pocket Max requirements for care received from 06/01/2020 - 07/31/2020 will apply to the 19/20 Policy year.  Deductibles and out of Pocket Max reset effective 08/01/2020 and care received from 08/01/2020 – 7/31/2021 will apply to the 20/21 policy year. 

Student Health Insurance Plan Information 2019/2020 - effective 08/01/2019 - 07/31/2020

The student health insurance plan for the 2019/2020 academic year is offered through Aetna Student Health and administered by Health Sciences Assurance Consulting (HSAC). Plan details include:

 Deductible  $250
 Co-Insurance  80% – Preferred Provider Organization (PPO), 60% – Non-PPO
 Out of Pocket Maximum (Individual)  $6,350 (PPO), $10,000 (Non-PPO)
 Out of Pocket Maximum (Family)  $12,700 (PPO), $20,000 (Non-PPO)
 Office Visit  $20 Copayment, 100% (PPO), 60% (Non-PPO)
 Urgent Care Visit  $20 Copayment, 100% (PPO), 60% (Non-PPO)
 Emergency Room Visit  $200 Copayment (Waived if Admitted)
 Prescription Drugs  $15/$25/$45

 

 

 

 

 

 

 

 

Student Health Insurance Plan Premiums 2019/2020 - effective 08/01/2019 - 07/31/2020

Student health insurance charges for the 2019/2020 academic year are listed below but are subject to change pending final state approval:

Program

Coverage Start Date

Coverage End Date

Annual Premium

Fall Semester

Spring Semester

MSMS 2020

06/01/2019

07/31/2020

$4,260.99

$2,130.50

$2,130.49

ISAC 2023 - DO, DONW, DPM 

06/01/2019

07/31/2020

$4,260.99

$2,130.50

$2,130.49

IPBP 2022

07/01/2019

07/31/2020

$3,973.29

$1,986.65

$1,986.64

CGN (Incoming Students)

07/30/2019

07/31/2020

$3,695.18

$1,847.59

$1,847.59

All Other Student Groups

08/01/2019

07/31/2020

$3,676.00

$1,838.00

$1,838.00

MSBS, MSHS, MSPS, Spring Starts*

01/01/2020

07/31/2020

$2,138.52

 

$2,138.52

DMD-IDP

03/01/2020

07/31/2020

$1,540.71

 

$1,540.71

Dependent Coverage

Qualified dependents can be added to the student health insurance plan. The coverage dates and rate would be the same as the student’s coverage dates and rate; however, the premium cannot be charged to your student account. The entire premium for dependents is due at the time of enrollment. You will be able to add dependents when you enroll in the plan or due to a qualifying life event (involuntary loss of coverage, birth or adoption).

Obtaining Your Student Health Insurance Plan Materials

If you enrolled in the student health insurance plan, you can access your insurance plan ID card, search for providers, view claims information and review benefits via the Aetna Student Health website.

Waiving Out of the Student Health Insurance Plan

If you have active health insurance with benefits that meet all the criteria listed below, you may apply for waiver of enrollment in the WesternU plan. You will need to have your current insurance ID card and information regarding your plan benefits to complete the process. A copy of the front and back of your Health Insurance ID card must be submitted with your request. Once you have submitted the required information, you will receive an email verifying if your waiver meets the WesternU requirements. Waivers will not be accepted past the required deadline. ** If you have recently applied for Medi-Cal and have received your approval letter but not your ID cards, please contact Medi-Cal and request your ID number so that you may submit your waiver prior to receiving you ID cards.

Acceptable Waivers 

  • All students MUST be covered by an ACA compliant domestic health insurance plan for the entire academic year, including summer and holidays.
  • The acceptable coverage to waive the WesternU - Sponsored Student Health Insurance Plan is a parent's employer group plan, a spouse's employer group plan, a student's own employer group plan, VA Benefits or COBRA. Individual Plans will be accepted for the 2020/2021 Policy year as long as they meet the University’s waiver requirements. Additionally, the University will allow students to waive out of the student health insurance plan using Medicaid based coverage that originates in the state of California (Pomona campus students) or the state of Oregon (Lebanon campus students). The University will not approve any other state’s Medicaid coverage as an acceptable waiver, subject to the Distance Education Program exception below.
    • Please Note: To be eligible to waive with COBRA coverage you must provide proof of payment on a monthly basis to the office of HSAC.
  • Distance Education Program Exceptions: Students participating in distance education programs such as those offered by the College of Graduate Nursing or the DPT (Post-Professional) program may waive out of the student health insurance plan using Medicaid based coverage that originates in the state in which they currently reside.  
  • Please note, students in programs that are currently being delivered through distance education as a direct result of COVID-19 do not qualify for the student health insurance exemption.

           • Deductible MUST NOT be more than $1,000 individual or $2,000 family annually, NO Exceptions.

           • Adequate major medical coverage of at least $1,000,000/policy year

           • Prescription coverage

           • Mental health coverage

           • Coverage for an annual exam

           • A provider network in the area of your WesternU campus for primary care, specialty, hospital, and diagnostic care. Students attending online                               programs, including those that are only partially online, are exempt from this requirement.

Limitations Regarding Out of State Rotations/Clinical Experiences: California or Oregon based students who waive out of the student health insurance plan using their respective state’s Medicaid based coverage may only be eligible for coverage of emergency services while completing clinical rotations/experiences out-of-state. Some of the University’s out-of-state clinical rotation/experience sites may require that you have comprehensive health insurance coverage; therefore, you may not be eligible to attend certain clinical rotation/experiences using Medicaid based coverage. Students using Medicaid based coverage while completing a clinical rotation/experience out-of-state are responsible for all medical expenses incurred that are not covered by their Medicaid based plan. Graduating students completing clinical rotations/experiences out-of-state that match to an out-of-state residency program during their final year should note that their out-of-state placement may cause them to lose eligibility for their respective state’s Medicaid based coverage.

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

If an acceptable waiver is not received by the posted waiver deadline, your enrollment in the student health insurance plan will be finalized, you will no longer be eligible for a refund of the fall 2020 premium, and your student account will automatically be assessed the applicable spring 2021 premium during registration.

Health insurance plans approved during the waiver process will be verified periodically to ensure students remain in compliance with the University’s health insurance coverage requirements.

Waiver Submission Deadlines

Program/Class Year

Waiver Submission Deadline

MSMS 2021 6/30/2020
DPM-AS 2022 6/30/2020
ISAC 2024(DO, DONW, DPM) 6/30/2020
IPBP 2023 7/31/2020
CGN (Incoming Students) 8/31/2020
All Other Programs/Class Years 8/31/2020
MSBS, MSHS, MSPS Spring Semester Starts 1/31/2021
DMD - International Dentist Program 3/30/2021

 

 

 

 

 

 

 

 

To ensure that health insurance coverage requirements are met, all full-time students are automatically assessed for half of the annual student health insurance premium upon registration for fall. 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 enrollment in the student health insurance plan is finalized. In addition, you are no longer eligible for a refund of the first half of the premium and you will automatically be assessed the second half of the premium upon registration for the spring term.

Waiver Appeals

If your waiver is denied, you may appeal the decision. The University will only override the waiver denial if you meet one or more of the following criteria:

  • As the student you are enrolled on a parent, guardian or spouse’s health insurance plan and the responsible party signs the High Deductible Appeal Form on your behalf. 
  • You are able to provide documentation (current statement) of a health savings account that holds a balance that will cover the difference between your health insurance plan deductible and the University’s $1,000.00 deductible requirement.

Instructions and deadlines for submitting your waiver appeal will be provided in your waiver denial email. Final Approval of your Waiver Appeal is the decision of WesternU.

Periodic Waiver Verifications

If your waiver is approved, it is still subject to periodic verification throughout the academic year to ensure the plan you submitted is still active and still 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 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 parents’ 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 dates of enrollment. Students have 30 calendar days after an involuntary loss of coverage to enroll in the student health insurance plan or submit updated proof of coverage. 

Students must maintain continuous enrollment in health insurance. If you are submitting new proof of coverage, it must begin within 24 hours of the termination of your previous coverage.  You are not eligible to waive if you have any gap in coverage.

Obtaining your 1095-B form for 2019 -  

Distribution of the form 1095-B has changed for the 2019 tax year. The form will be available for 2019 on the Aetna member’s portal under “communication”.

  • The form shows if a member met the Affordable Care Act (ACA) minimum essential coverage requirement known as the individual mandate. Because the tax penalty for failing to meet this mandate has now been reduced by Congress to zero, the IRS indicated in its notice that “an individual does not need the information on Form 1095-B in order to compute his or her federal tax liability or file an income tax return.”  

As there is no penalty regarding minimum essential coverage, the form will no longer be mailed to a member’s address, with the exception of New Jersey and Washington D.C which still require a paper form be mailed to members.  Forms were to start becoming available on 01/20/20 for the 2019 reporting year.

Students can view/print their tax form online in the member portal under “Messages” under the “Letters and Communications” tab.  If they don’t want to go through the portal, students should call 1-855-531-6837 to request a duplicate form.  If they need as SSN updated the student can update the SSN online via the member portal and immediately see the corrected 1095b form online there.

Questions and Contact Information

The Servicing Administrator for the WesternU - 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 WesternU student or you may send an email to westernu@hsac.com