Insurance Information 2015-16

To: Enrollees of UC Student Health Insurance Plan (UC SHIP)

RE: UC SHIP Santa Cruz Plan Recognition as Minimum Essential Coverage (MEC)

Please see this Link 

** Newsflash **

MY FORM 1095-B

Forms 1095-B will be postal-mailed to UC SHIP members by March 31st.  This Form confirms your health plan is compliant with the Affordable Care Act (ACA).

Individuals do not have to wait for their Form 1095-B in order to file their tax return. 

In late December, the IRS extended deadlines to furnish 1095-B forms to plan members.  Due to this extension, some individual taxpayers may not receive a Form 1095-B by the time they file their 2015 tax return. While the information on this form may assist in preparing a return, it is not required. Like last year, taxpayers can prepare and file their returns using other information about their health insurance.   See https://www.irs.gov/Affordable-Care-Act/IRS-Extends-Due-Dates-for-New-2015-Information-Reporting-Requirements

The Internal Revenue Service released Notice 2016-4 extending due dates for providing the form 1095-B to health plan members and submission of member information to the IRS, see below. Consult your tax adviser if you have questions.

  • Filing member information with the Internal Revenue Service due date is changed from March 31, 2016, to June 30, 2016.
  • The due date for furnishing the 2015 Form 1095-B to covered individual is changed from February 1, 2016, to March 31, 2016.

For more helpful ACA information go to:  https://www.irs.gov/Affordable-Care-Act

** Newsflash **

NEW PHARMACY INSURANCE PROVIDER (CATAMARAN).  For prescriptions at outside pharmacies, the following information is required in addition to your Anthem subscriber#:

Group #:  UCSHIP

BIN: 610011

PCN: IRX

Catamaran Customer Service: (844) 265-1879

Anthem Customer Service: (866) 940-8306

** Newsflash **

Wells Fargo Insurance is the waiver administrator for UC SHIP.  In addition, we have been contracted by the UC Office of the President/UCSC to conduct waiver audits for UCSC.  As part of our audit process, we may require a student to complete the Authorization to Release Protected Health Information form in order to complete the audit.  For verification purposes, the form contains a section requesting an “Account ID or Social Security Number.”  You are required to provide the Account ID (Subscriber ID or Health Plan Member ID#) associated with your existing health insurance plan.  You are not required to provide your Social Security Number(SSN)unless it is also your Account ID (i.e., military health plans).  Please do not ignore this request as failure to respond will result in automatic failure of the audit and you may be charged and enrolled into UC SHIP.

 

WELLS FARGO INSURANCE PRIVACY INFORMATION

We know that your privacy is important to you and we strive to protect the confidentiality of your personal information. We do not disclose any personal information about our plan participants, except as permitted or required by law (e.g., information you provide to us may be shared with your school to process your insurance transaction). To protect your personal information from unauthorized access and use, we use security measures that comply with federal law. These measures include computer safeguards and secured files and buildings. You may obtain a detailed copy of our privacy policy through your school or by calling us at (800) 853-5899 or by visiting us at studentinsurance.wellsfargo.com.

***

Our Billing and Insurance Advocates are happy to assist you with all your medical billing and insurance needs.

Insurance Requirement

The University of California Regents mandate that all students be covered by a health insurance plan. All full and part-time undergraduate and graduate students are automatically enrolled in and charged for the University of California Student Health Insurance Plan (UC SHIP) unless they choose to submit an on-line insurance waiver confirming they have acceptable health insurance coverage.

University of California Student Health Insurance Plan (UC SHIP)

What is UC SHIP?

UC SHIP is an affordable health insurance plan tailored to the health care needs of UCSC students. The medical plan features year-round, world-wide coverage using the Anthem Blue Cross network, and includes prepaid access to care at the UCSC Student Health Center for illness or injury. This means students can receive convenient, high quality on-campus care when they are sick or injured without having to be concerned about cost or availability of the care they need.  Preventive health care visits are covered at the Student Health Center at 100%. As part of UC SHIP students have access to a comprehensive prescription drug formulary administered by Catamaran. The UC SHIP plan provides optimal coverage for services on campus and in the Santa Cruz community, and peace of mind for both parents and students. A referral is REQUIRED for ALL off-campus care with the exception of urgent or emergent care. The dental plan is provided by Delta Dental; the vision plan is provided by Anthem Blue Cross (see plan brochures for detailed benefits). To direct access the UC SHIP web site please click here.

UC SHIP fees 2015/16

Undergraduate Students

For 2015-2016 the undergraduate plan costs just $878 per quarter, paid three quarters per year. The Spring payment covers both Spring and Summer quarters so coverage is year-round -- an affordable $220 per month for convenient, accessible, world-wide health insurance coverage, dental coverage, and vision coverage.

Graduate Students

For 2015-2016 the graduate plan costs just $1,314 per quarter, paid three quarters per year. The Spring payment covers both Spring and Summer quarters so coverage is year-round -- an affordable $329 per month for convenient, accessible, world-wide health insurance coverage, dental coverage, and vision coverage.

Voluntary Insurance Enrollment

  • Some student not taking classes but still affiliated wih UCSC may qualify for UC SHIP if they were on UCSHIP the previous quarter.
  • Students on Planned Educational Leave (2 quarters limit)
  • Graduate students on Filing Fee status (1 quarter limit)
  • Students who have graduated (1quarter immediately following graduation only)
  • Dependents of eligible undergraduate or graduate students

Considering Waiving UC SHIP?

IMPORTANT!  UC Santa Cruz requires that all students have a primary care provider within 30 miles of their school address (on or off campus). Many students with Kaiser, Medi-Cal, or HMO insurance cannot meet this require­ment. If you cannot identify a provider within this 30 mile radius, you may not qualify to waive the UC SHIP.  If you are receiving Financial Aid, please check with the Financial Aid office to see if UC SHIP or CruzCare is included.

Students and their parents should first ask: "Are We Really Covered?" Consider the following:

  • If you have Kaiser as your insurance plan. Before waiving UC SHIP, we ask you to consider the distance from campus to the nearest Kaiser facility. There is no Kaiser facility in Santa Cruz County. The nearest Kaiser facility is "over the hill" in San Jose (it takes 3 bus rides and over 1 hour). There is no direct public transportation to get there, and a sick or injured student may not be well enough to spend hours on multiple bus rides just to get there. For families who live close enough to drive their student or the student has a car, Kaiser may be an option. For families not within an hour or so of Santa Cruz, UC SHIP is recommended.
  • If you have an HMO plan such as Health Net, Aetna, as your insurance plan. Before waiving UC SHIP, please note that the HMO plan only covers you for medical care from your designated primary care provider or upon referral from that person. It is not automatically a portable plan. In order to seek non-emergency care in Santa Cruz County using this plan, the student must select a new doctor in our area and transfer their care to that person.
  • Most HMOs and PPOs, including Kaiser, PacifiCare, and Health Net, will NOT cover care provided on-campus at the UCSC Student Health Center, requiring students to travel off campus even when care could be provided at the Student Health Center. The UCSC Student Health Center and UCSC health care providers are not contracted with any insurance companies. Before making a decision to waive UC SHIP, check with your insurance carrier to verify whether or not charges incurred at the UCSC Student Health Center are covered.
  • Most HMO and PPO plans will only cover laboratory tests, X-rays, or care by specialists when the order or referral is made by the student's primary care physician. Students coming to UCSC from other locations may have to return home to have care authorized.
  • Many students enroll in UC SHIP to supplement their existing coverage for services at the Student Health Center and in the Santa Cruz community that HMO plans do not cover.

Accepting or Waiving UC SHIP

To accept enrollment in UC SHIP no action is necessary; you will automatically be enrolled and billed for the Fall quarter premium in August and coverage will begin 9/19/15. A booklet describing the plan benefits and conditions is available online.

To waive out of UC SHIP for 2015-2016 you must complete an on line waiver. Note: Once accepted, the waiver is in effect for the current quarter and the remainder of the academic year.  A new waiver must be submitted at the beginning of each academic year.

If you have acceptable health insurance coverage and are sure that you want to waive UC SHIP, follow these instructions:

  1. Review and complete the On-line Waiver Questions worksheet before beginning the waiver process.
  2. Navigate to the UCSC Waiver Site (will convert to fall 2015 on 7/6/15) and complete the on-line waiver.

If you do not have access to a computer, or for waiver assistance, please contact the Student Insurance office at 831-459-2389 or email insure@ucsc.edu

If you are on someone else's insurance you have privacy rights. See this website on how to Keep It Confidential(http://myhealthmyinfo.org/) to learn more about your privacy rights.


ACA SSN Requirements: Formal Request for Social Security Numbers from Wells Fargo Insurance Services - 

To comply with the Affordable Care Act, the UC SHIP insurance plan, Anthem Blue Cross, via our insurance broker, Wells Fargo Insurance Services, will be requesting Social Security Numbers so that they can submit required information proving that members have health insurance.  Please see these links for more information.


Waiver deadlines for 2015-2016:

Fall: 9/1/15
Winter: 12/11/15
Spring: 3/1/16

UC SHIP and Financial Aid

If you wish to discuss your options for covering the cost of UC SHIP premiums, you may contact the Financial Aid office at 831-459-2963.

Financial Aid will need to know that our office has reviewed and denied your request to waive UC SHIP.

The Student Health Center cannot advise you on the various ways to cover the cost of UC SHIP.  Please discuss this question with Financial Aid and be sure to let them know that your request for a waiver has been denied.

CruzCare - Prepaid Access to the Student Health Center (available only for students who successfully waive UC SHIP)

If you choose to waive UC SHIP coverage consider purchasing CruzCare, an inexpensive pre-paid access plan for busy students seeking on-campus health care. For $90 a quarter (applied automatically to the student's account) CruzCare provides unlimited Student Health Center visits for care of illness or injury, including in house Health Center laboratory and X-ray. For students waiving UC SHIP, CruzCare is the best and most cost effective way to take advantage of the on-campus convenience and college health expertise available at the UCSC Student Health Center.  Because the cost of a simple visit for a common student health problem like sore throat, urinary tract infection or sprained ankle exceeds $100 with physician visit, laboratory or X-ray charges, CruzCare pays for itself with a single visit to the Student Health Center.

What is covered by CruzCare:

  • Unlimited health center visits for care of illness or injury
  • Unlimited in-house health center laboratory tests for illness or injury
  • Unlimited in-house health center X-ray exams for illness or injury

What is not covered:

  • Off campus care, including laboratory tests sent to the off campus lab
  • Medications, supplies, and immunizations
  • Special or elective procedures and tests
  • Prescriptions and Over-the-Counter medications
  • Routine clearances and health maintenance visits
  • Off campus referrals for specialist care

How do I enroll in CruzCare? Is there a deadline?:

  • Enrollment in CruzCare is part of the on-line waiver process.  If you were unable to enroll through the on-line waiver – or you wish to cancel CruzCare, please submit the CruzCare Enrollment/Cancellation Form via fax or mail by the deadlines posted below
  • Once you enroll you will be billed each subsequent quarter.
  • Only registered students who successfully waived UC SHIP are eligible to enroll in CruzCare
  • The deadlines to purchase for the 2015-2016 Academic Year (summer excluded)*:

    Fall: 9/1/15
    Winter: 12/11/15
    Spring: 3/1/16

*NOTE REGARDING LATE CRUZCARE ENROLLMENT: We will accept one late CruzCare enrollment during your academic career and you will be enrolled for the remainder of the academic year (summer excluded).