Question: I participated in the Student Health Insurance Plan with Bollinger/Monumental Life for Academic Year 2011-2012 which expires August 14, 2012. What does this mean if the new policy starts prior to this date?
Answer: Bollinger will handle this situation as a Coordination of Benefits. Coordination of Benefits is the process of determining which of two or more insurance policies will have the primary responsibility of processing/paying a claim and the extent to which the other policies will contribute. In this case, both Bollinger/Monumental Life policies will be in effect during the overlap. Of the two Bollinger/Monumental Life policies in effect at the same time, the policy expiring August 14, 2012 will be primary. You should check any other insurance coverage you may have to see which policy would be considered primary.
Question: Do I get a refund for having the two SHIP policies in effect at the same time?
Answer: No. Both policies are still offering you coverage.
Question: Can I opt out and then enroll in SHIP after August 28?
Answer: Opting out and then opting back in after August 28, 2012 would not result in a reduced or prorated premium. The full premium would still have to be paid and the expiration of the policy would be the same as if you had started the policy June 30, 2012. The start date of your coverage would be the date you opt in. Retroactive coverage is not available.
Question: If the new SHIP policy is written for a year, what happens when I reach the expiration of the policy at the end of June in 2013?
Answer: If the policy year start date for Academic Year 2013-2014 is reset to start August 15, 2013, TCNJ will ask Bollinger/Monumental Life to extend the Academic Year 2012-2013 policy to expire August 14 so there is no lapse in coverage. In New Jersey, health insurance policies cannot be written initially for more than 12 months, but they can be extended. It is possible that the expiration date of the policy will not be extended. If you are ineligible or do not wish to participate in the plan offered in Academic Year 2013-2014, then you would need to personally locate alternative coverage to prevent any lapse in coverage.
Question: If the Academic Year 2012-2013 policy term is extended, does this mean I need to pay additional premium?
Answer: There will be no additional premium charged to students in the event the policy term is extended to realign the start date for the following year to August 15.
Question: If the Academic Year 2012-2013 policy term is extended, what does this mean for my benefits and limits of coverage?
Answer: The benefits and limits of coverage are not increased. The policy duration is all that changes. This means that if you exceed your benefit limits within the first 12 months of the policy year, you will not have any additional coverage if the policy term is extended. If you encounter or anticipate such a situation, you may wish to seek alternative health insurance coverage. To address the potential policy term extension and the need for additional prescription benefits (one of the most common coverage needs), the prescription benefit for Academic Year 2012-2013 is being increased from $300/year to $500/year.
Question: If I opt out and decide not to participate in SHIP for Academic Year 2012-2013, what are my options?
Answer: In the State of New Jersey, all full-time college students are required to carry health insurance. To be able opt out of the Bollinger/Monumental Life plan, as a full-time student you must present evidence of health insurance to the college and meet the opt out deadline of August 28, 2012. As a part-time student you are not automatically enrolled and must ask to opt in by September 15, 2012. If you need to obtain other health insurance coverage, you have a number of options. You may be eligible for coverage under a group health plan of a parent’s employer or under a parent’s individual health insurance policy if you are under the age of 26. Contact the plan administrator of the parent’s employer plan or the parent’s individual health issuer for more information. If you are over the age of 26 or if you are not eligible for coverage under a parent’s employer or individual policies, then you may be eligible for coverage under an individual policy or through programs such as COBRA.
Question: If I use SHIP prior to receiving my student bill, am I still able to opt out?
Answer: No. You cannot opt out after using the policy. Use of the policy indicates acceptance of coverage and the requirement to pay the premium.
Question: If I am covered by my parent’s insurance plan, why would I need SHIP?
Answer: We find that most students do not understand how their health insurance and prescription coverage works or what it covers. Some plans cover non-emergency expenses only if the college is within the plan’s geographic area. Some require referrals for certain services or lack coverage for out-of-network providers. Most plans require the patient to pay high co-pays and deductibles before benefits begin. Some prescription cards can only be used at network pharmacies that are often inaccessible to college students without personal transportation. Some students will not see a health care provider for a reproductive health problem because the use of their parents’ insurance will compromise confidentiality. These issues complicate and delay health care needed at college. In view of the value of this plan, the benefit of no co-pays or deductibles and our experience with the health care needs of our students, we strongly encourage students to enroll in this plan even if they have other health insurance.
Question: I am covered by my parent’s health insurance plan. I am interested though in keeping SHIP as a supplement to my existing insurance plan. Which plan would be considered “primary”?
Answer: When using SHIP in conjunction with other primary insurance, you must be certain to abide by all terms and conditions of your other policy.
Question: Let’s say I am sick and need to see someone. What do I do?
Answer: Call Student Health Services and make an appointment. There is no charge to see a doctor or nurse practitioner for sickness or injury.
Question: How about if I live an hour away and I get sick? Or what if I get sick when Student Health Services is closed?
Answer: Call your doctor or local urgent care clinic and make an appointment to be seen. Take your SHIP insurance ID card and a claim form with you. Some doctors’ offices will ask that you pay them up-front for your visit. They will give you a receipt of payment which you will then submit to SHIP, along with a Claim Form (available at www.bollingerinsurance.com/tcnj), to Bollinger Insurance Solutions. Some offices will submit the claim form for you. SHIP will cover $80 of your doctor’s visit. If laboratory tests and/or x-rays are performed, SHIP will cover up to $600 of charges. If prescription medicine is needed, use your CareMark card to obtain your medicine from any pharmacy (max of $500 for the policy year).
Question: What if I have an illness or injury that needs emergency care?
Answer: Go to the nearest emergency room. If you are on campus, dial 9-1-1 from any campus telephone or 609-771-2345 from a cell phone to summon medical assistance. Ambulance is covered up to $300 per transport. Emergency Room coverage is up to $1,500 per problem.
Question: I need to see a dermatologist for a rash I have. Will SHIP cover these visits?
Answer: SHIP will pay up to $80 per visit to an $800 maximum for this problem. Preferably choose a dermatologist who is in the SHIP CHN network by going to http://www.csg-inc.net/chn_ppo.htm . CHN providers will accept $80 per visit and not bill you for the difference if their usual office visit is higher. Non-CHN providers will balance bill you. Many health care providers want to be paid in full by the patient at the time of service. They will then submit your bill for you and instruct the insurance company to reimburse you up to the limits of the policy. Usually CHN providers do not expect payment up front at the time of services but this varies from provider to provider. Please inquire about their policy when you call to make an appointment.
Question: What if my doctor orders laboratory tests when I’m sick? Is this covered?
Answer: Yes, laboratory tests and x-rays are covered for illnesses up to $600 per problem.
Question: Can I use the Prescription Card to pay for a prescription that was ordered by a doctor outside of Student Health Services?
Answer: Yes. Just take your Prescription Card and prescription to any pharmacy. Remember that the allowance for the entire policy year for prescriptions is $500 for the policy year. You will not pay a co-pay or deductible. The prescription benefits has NO waiting period for pre-existing conditions.
Question: I need a physical examination to study aboard. Will SHIP cover it?
Answer: Yes, as long as you haven’t used any benefit from the Wellness portion of your plan ($230 maximum allowance). You can also schedule most physical examinations at Student Health Services as long as you are currently taking classes. There is a $20 charge for this service.
Question: Can I still use Student Health Services if I waive enrollment in SHIP?
Answer: Yes. Any TCNJ student currently taking classes can use Student Health Services. However, we are out-of-network providers for all insurance plans. That means that although there is no charge for a basic office visit, your insurance may not cover the tests we order, or cover them at full benefit. In addition, Quest Diagnostics and Lab Corp (referral labs), Quakerbridge Radiology Associates (x-rays), Quick Chek Pharmacy (prescription medicines with free delivery to campus), and local hospitals (x-rays, EKG, emergency room) and their physician groups may not accept your insurance.
Question: Why is the student health insurance plan so important at TCNJ?
Answer: College-sponsored health insurance plans are tailored to the school’s student health services and greatly facilitate the use of these services. This is the greatest benefit of the student health insurance plan. Enrollment in the student health insurance plan allows students to take full advantage of the services offered conveniently on campus by providing coverage for necessary laboratory testing, medical supplies, vaccinations, x-rays, and most prescription medication.
Question: Can I use SHIP outside of Student Health Services?
Answer: Yes, you can submit bills for covered health care services provided by a licensed health care provider located anywhere in the world. Please contact Bollinger BEFORE leaving the U.S. to discuss coverage. The purchase of traveler’s insurance is still recommended for all individuals traveling abroad regardless of type of U.S. health insurance coverage.
Question: How many TCNJ students are enrolled in SHIP?
Answer: Over 50% of full-time undergraduate and graduate students were enrolled in the SHIP during the 2011-12 academic year. Most of the undergraduate students who have SHIP have other health insurance through a parent because they or their parents have decided to supplement their existing health insurance plan.
Question: I won’t be using Student Health Services (SHS) when I’m sick because I have my own doctor. So I won’t need student insurance, right?
Answer: First, student insurance can be used off-campus. Second, using Student Health Services is usually much more convenient if you live on-campus or if your doctor is some distance from the College. Student Health Services’ nurse practitioners and physician have the advantage of knowing what infections are circulating on campus and they are specialists in adolescent and young adult medicine. This gives SHS’ clinicians a tremendous edge when diagnosing a student’s illness. SHS is tailored to the needs of the TCNJ college student. For example, prescription medicine is delivered back to SHS by the pharmacy free-of-charge at the end of each day. Sometimes, a sudden or severe illness or injury may not provide you with time to get home to see your own doctor. Lastly, you never know when you may need first aid while on campus.
Question: If I keep SHIP, should I still bring my other health insurance cards with me to school.
Answer: Yes. You should always carry all health insurance cards (Medical, Dental, and Prescription) or a copy of the front and back of the cards with you. Please learn some basic facts about how your insurance works.
Question: What if I don’t have any other insurance? Is TCNJ SHIP adequate?
Answer: Individual health care needs vary among our students. Therefore carefully review the coverage, policy limits, and exclusions of the Student Insurance Plan. Students interested in more comprehensive health insurance coverage can contact Larry Shoemaker, Senior Vice President, Bollinger Insurance, at 973-921-8086 for quotes on individual health insurance policies. You may also log on to the New Jersey Department of Banking and Insurance, eHealthInsurance, and MyInsuranceExpert.com web site for information on individual health insurance. Don’t forget to investigate whether or not you are a candidate for COBRA.
Question: Who can enroll in SHIP?
Answer: The TCNJ student health insurance plan is available to all registered students. There is no minimum credit hour requirement for eligibility.
Question: How do I enroll in the SHIP?
Answer: Full time students will be billed for student health insurance each semester on their tuition bill and automatically enrolled in SHIP. Enrollment forms for interested part-time students are located on the Bollinger Insurance Solutions’ website at www.bollingerinsurance.com/tcnj . Enrollment is open until September 15, 2012.
Question: I enrolled in SHIP but where are my insurance cards?
Answer: The SHIP health insurance ID card and Prescription card are available for download on the Bollinger Insurance Solutions’ web site at www.bollingerinsurance.com/tcnj after July 1, 2012 . Print them both out and put them in your wallet.
Question: Do I have to have health insurance to attend college?
Answer: All full-time college students are required by New Jersey law to maintain health insurance with at least basic hospital benefits while attending a New Jersey college or university. Therefore, if you are registered as a full-time student and do not have other health insurance, you must enroll in this plan or another comparable plan with basic hospital benefits. Health insurance is not mandatory for part-time students.
Question: Can I enroll in SHIP if I am only taking one class?
Answer: Yes. Enrollment forms for interested part-time students are located on the Bollinger Insurance Solutions’ website at www.bollingerinsurance.com/tcnj .
Question: Is SHIP an secondary policy, like athletic insurance?
Answer: No. SHIP can be used as a stand-alone plan or as a supplement to other existing insurance. When using this policy in conjunction with other primary insurance, you must be certain to abide by all terms and conditions of your other insurance.
Question: Does SHIP pay for prescription medicines?
Answer: Yes, for covered illnesses and accidents, there is a total benefit of $500 for the policy year for prescription drug coverage (no deductibles or claim forms). Birth control prescriptions are covered.
Question: Does SHIP cover vaccinations?
Answer: Yes, vaccinations recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP) for the U.S. are covered up to the limits of the Wellness Benefit portion of the policy: $230 for the policy year. These vaccinations include hepatitis A and B, HPV (e.g., Gardasil), chickenpox, tetanus, pertussis, etc. SHIP also provides a $20 flu vaccination benefit in addition to the $230 Wellness Benefit. Please note that all these vaccinations are available at SHS at a reduced cost.
Question: Does SHIP include dental coverage?
Answer: Coverage is limited to expenses incurred from an injury to sound, natural teeth and for impacted wisdom teeth extraction (see policy for limits). Bollinger Insurance Solutions does offer an optional discount dental plan to students. Call the student insurance company at 1-800-526-1379 for details or visit the Bollinger TCNJ website at www.bollingerinsurance.com/tncj .
Question: How long do I have to send in a claim form to get my bills paid?
Answer: Within 90 days after loss occurs or as soon as reasonably possible.
Question: Where can I get a claim form?
Answer: Download Claim Form
Question: Does the student insurance prescription plan pay for birth control prescriptions?
Answer: Yes, up to the limits of coverage ($500 total prescription coverage for the policy year).
Question: What if I have a complaint about SHIP. Where do I go?
Answer: Contact Sandra Whaley, Student Health Insurance Coordinator, at 609-771-2484 or via e-mail at swhaley@tcnj.edu.
Question: Does the student insurance cover pre-existing conditions?
Answer: Generally, yes. For exclusions, contact Bollinger directly at 1-800-526-1379.
Question: I am playing football at TCNJ. Will this insurance cover me if I get hurt?
Answer: No. SHIP will not cover injuries that result from intercollegiate sports, only those sustained during intramural and club sports. The College provides athletic insurance for intercollegiate sports injuries which is an excess policy after private insurance. Athletic injuries and the insurance are coordinated by TCNJ’s Head Athletic Trainer, Megan Guicheteau, phone #: 609-771-3402.
Question: I will be registered for less than 3 units this semester which is part-time. Therefore I won’t automatically be enrolled in SHIP. How soon do I need to submit an enrollment form and payment?
Answer: The enrollment period ends on September 15, 2012. Exceptions for enrollment in SHIP after the enrollment period has ended are made for students who have lost their health insurance.
Question: I was covered by my mother’s health insurance plan through her job and I waived out of SHIP. But my mother lost her job and her health insurance was just terminated. The enrollment period has passed and I need health insurance. What do I do?
Answer: Obtain the health insurance termination letter that your mother received and take it to TCNJ Student Accounts, 119 Green Hall. If the letter is acceptable evidence of a termination of health insurance coverage, Student Accounts will provide you with a SHIP enrollment form. Pay your $324 premium to Student Accounts. Your coverage becomes effective the same day.
Question: Where can I find out more about benefits, coverage, claims procedures, and exclusions?
Answer: Go to the Bollinger Insurance TCNJ website at www.bollingercolleges/tcnj after July 1, 2012. For additional information about the insurance, contact Bollinger directly at 1-800-526-1379.
For more “Frequently-Asked Questions & Answers”, go to the Bollinger website at www.bollingercolleges.com/tcnj/
