Oklahoma State University

Graduate Assistant/Associate

Health Insurance Coverage

Congratulations! Oklahoma State University is pleased to offer insurance coverage for Graduate Assistant/Associates. The University provides full payment of the student's coverage if you meet the eligibility requirements.

Eligibility

1.      You are eligible for Graduate Assistant/Associate health insurance coverage if you are a graduate student who is:

- Teaching Assistant or Associate (TA), Graduate Assistant or Associate (GA), or Research Assistant or Associate (RA), and

- Working .25 FTE or more throughout the semester and meeting all other eligibility criteria to hold the assistantship, and taking nine or more graduate credit hours, (spring and fall, 3 hours summer) Or

- Working .5 FTE or more throughout the semester and meeting all other eligibility criteria to hold the assistantship, and taking six or more graduate credit hours, (spring and fall, 3 hours summer).

2. The University provides full payment for the student’s coverage, on a semester-by-semester basis, if you meet these eligibility requirements. Students whose assistantship begins with the first day of the semester (fall, spring, or summer) will be covered on the first day of the semester, if all paperwork has been signed and approved.
3. Students whose employment begins after the first day of the semester—but before October 15 (for fall appointments), March 15 (for spring appointments), or June 15 (for summer appointments)—will be covered on the first day of the month following the assignment date. Students whose employment begins after the above dates will not be eligible for coverage to be paid by OSU during that semester.
4. Students who are eligible for the Graduate Assistant/Associate health insurance coverage for summer and fall, or fall only, will be covered until the day before the first day of the next semester.
5. Students who are eligible for the Graduate Assistant/Associate health insurance coverage during the spring semester and have an active pay assignment on May 1 will have coverage in effect until the day before the first day of the fall semester.

You have the option of declining this coverage. See Page 2, "Enrollment."

University Health Services
Graduate Assistant/Associate health insurance coverage is designed to be mutually complementary with the OSU University Health Services. The University Health Services (UHS) is a one-stop health service available to all currently enrolled OSU students. The UHS is located at 1202 Farm Road, across from Kerr-Drummond Hall and next to Iba Hall.

Coverage

Insurance coverage is under the Ace American Insurance Company administered by Academic Risk Management. The current policy brochure is available for downloading at: http://www.academichealthplans.com/okstate or at the Graduate College Office, 202 Whitehurst or at University Health Services on Farm Road. This insurance policy brochure explains the coverage.

Orientation sessions to explain coverage and insurance benefits will be held at the start of each semester. The locations will be announced in advance. It is strongly recommended that you attend one of these sessions so that you can understand your full coverage.

Your health plan identification (ID) card will be mailed to your local address by the insurance plan carrier after your coverage has been processed.  Please retain the ID card  and  present to a medical facility when receiving services.

You can obtain information on UHS services by looking at their website www.okstate.edu/UHS or by calling the University Health Services at 744-7013. An insurance representative is available to meet with you individually to answer questions.

You can also contact Health Special Risk at 1-800-328-1114 (Press one for the Dallas office) for inquiries about the payment of claims. Their office hours are Monday through Friday from 7:00 a.m. to 5:00 p.m. For inquiries about plan coverage, contact Academic Health Plans, 1-888-308-7320.

Enrollment 

1. When you become an OSU employee, you will have the option of declining health insurance coverage provided by the Oklahoma State University. If you do not opt out of it, you will automatically be covered. We recommend that you do not opt out, as the University pays the student’s coverage if the eligibility requirements are met.
2. When you file your first claim, you will need to sign an authorization to release medical records, which may be needed for payment of medical claims by Health Special Risk (HSR).
3. You should review the health insurance policy brochure and the UHS orientation session schedule. Tear or cut out the ID card from the health insurance policy brochure. Keep it in your possession.
4. Plan on attending an UHS orientation session. The orientation will give you an overview of the benefits, etc., of your coverage.
5. Enrollment for dependent coverage: You have the option of purchasing coverage for your dependents. The dependent coverage can be purchased in one of two ways.

• Go to www.academichealthplans.com and complete the necessary information to add a dependent, or:
• Go to UHS room 102 to complete an enrollment application.

Graduate Assistantship Appointment Terminated

Students who lose eligibility to hold their assistantship do not qualify to have future premiums paid by the University. See policy brochure for specific dates of coverage for each semester.

If you are not employed for a semester, you have the option of purchasing insurance coverage. See below for details.

Options for Continuing Coverage

• Self-Pay Option: As a student taking six or more hours of class, you can purchase the insurance plan. You can continue your coverage by filling out the insurance enrollment card and making the payment with check or credit card. For questions regarding this process, refer to the insurance policy brochure, contact the University Health Services, or contact Academic Health Plans.

We recommend that you consider this option, especially if you anticipate a "gap in coverage." If you don’t meet the criteria for OSU paid premiums during a semester but you anticipate that you will start another assistantship the next semester, purchasing the plan will allow you to maintain continuity of coverage.

• If you are graduating and need a continuation plan or short-term insurance, this is available through Academic Health Plans. You can refer to the insurance policy brochure for information on this, or call Academic Health Plans at 1-888-308-7320 to discuss which plan may be best for you.

Filing Claims

• Any charges for services at the University Health Services will be filed by the University Health Services directly with the insurance company. The student will be responsible for any charges not covered by the plan.
• The student will be responsible for filing claims for services received outside the University Health Services. For specifics on how to do this, refer to the insurance plan card.

Claims Appeal Process

You can elect to appeal a claim within 60 days of receipt of a claim payment or denial. Appeals should be made in writing and addressed to the Claims Manager at Health Special Risk. Please make sure that you attach any and all pertinent information which would document the reasons for the appeal. A written response will be forwarded upon final review of the appeal.

 Information Sources

For eligibility and general information:

OSU Graduate College

202 Whitehurst Contact: Jodie Kennedy, Fiscal/Financial Aid Officer

Phone: (405) 744-4806 kjodie@okstate.edu

For questions on insurance plan and available services:

OSU University Health Services (UHS)

Phone: (405) 744-7013

Office hours: Mon.–Fri., 8:00 a.m. to 5:00 p.m.

Contacts: Jack Henneha, Mgr. Bus. Ofc. jrh@okstate.edu

UHS website: http://www.okstate.edu/UHS

           

For inquiries about health plan coverage:

Academic Health Plans (AHP)

Phone: 1-888-308-7320

Office hours: Mon. – Fri. 8:00 a.m. to 5:00 p.m.

P.O. Box 1605

Colleyville, TX 76034-1605  

For inquiries about the payment of claims or appeal of claims:

Health Special Risk (HSR)

Phone: 1-800-328-1114 (press 1 for the Dallas Office)

Office hours: Mon.–Fri., 7:00 a.m. to 4:00 p.m.

4001 North Josey Lane, Carrollton, TX 75007