Insurance

WELCOME TO THE UNIVERSITY OF CALIFORNIA, IRVINE STUDENT HEALTH INSURANCE PLAN

The University of California requires all students to have major medical health insurance as a non-academic condition of enrollment. All full and part-time undergraduate and graduate students with a USHIP/GSHIP fee assessed are automatically enrolled in, and charged for, the Student Health Insurance Plan (SHIP). Students who demonstrate comparable health insurance coverage may submit an online request to waive out of SHIP.
Note: Once granted, the waiver is in effect for the current term and the remainder of the academic year. A new waiver request must be submitted at the beginning of each academic year
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Contents:

Insurance Plan
- For Undergraduates
- For Graduates

- UC SHIP & Healthcare Reform
- How to use SHIP

- Cost of SHIP

- Coverage Period

- SHIP Enrollment

 

For Graduates
- Voluntary Enrollment for Graduates
- HEMBA/FEMBA

- MPAC

- First Summer GSHIP

- Filing Fee
- Leave of Absence

-Continuation(Graduated)

- Dependent Enrollment

- After Graduation

Waiving SHIP
- On-line Waiver Info
- Waiver FAQ

Avoid the Bills

Unless it is for a Medical Emergency Care, you always need to obtain a referral issued by a Student Health Center Provider prior to seeking  outside services or your claim will be denied.

 

   

Student Health Insurance Office Contact Information:

Phone: (949) 824-2388
Fax: (949) 824-5062

E-mail:shc-insurance@uci.edu

Address:
UC Irvine Student Health Center

Insurance Office
501 Student Health
Irvine, CA 92697-5200

 Regular Office Hours
Monday-Friday: 9:00 am-4:00pm

 

 

 

 

UC SHIP Insurance Update:

 

WAIVER APPLICATION PERIOD FOR FALL QUARTER 2015-2016 WILL BEGIN 6-22-2015 AND WILL CLOSE ON 9-11-2015

 

* Fall Quarter waiver period start date has been changed from 6-1-2015 to 6-22-2015. *

 

 

Insurance Plan

 

Undergraduate Student Health Insurance Plan (USHIP)

 

Effective fall quarter 2001 the Regents of the University of California instituted health insurance coverage as a condition of enrollment for all undergraduate students. This link will take you to details explaining the Regents decision www.ucop.edu. This insurance is included in your student fees and enrollment in the plan is automatic when you pay your fees. You may waive out of this plan if you can demonstrate comparable and verifiable health coverage that meets the campus' minimum standards for insurance.

 

For the upcoming 2014-2015 academic year, Nationwide will continue to be the underwriter for UC Irvine’s Undergraduate Student Health Insurance Plan (USHIP). Personal Insurance Administrators, Inc. (PIA) is the benefit plan administrator of USHIP and CIGNA will be the preferred provider organization network (PPO). Please note that, although the USHIP plan is technically a PPO-type plan, students must first obtain a referral authorization from a Student Health Center primary care provider BEFORE seeking treatment from a non-SHC specialist. If a referral authorization is not obtained in advance for any outside services other than emergency care or mental health care, then the claim will be denied.
(Welcome Letter)

 

While many aspects of the SHIP will be the same as the previous year, the students will enjoy a number of enhancements due to the requirements mandated by the Affordable Care Act (PDF) and previous caps on many benefits have been removed.

 

 

Medical Benefits (Brochure)

(Summary of Benefits - Student Plan)

(Summary of Benefits - Dependent Plan)

 

The medical benefits of the plan are provided through Nationwide and administered by Personal Insurance Administrator (PIA).

For more information please visit www.4studenthealth.com/uci.

 

Customer Service: (855) 515-2423

PPO network: www.cigna.com

 

Vision Benefits (PDF)

Your Vision benefits are provided through Anthem Blue Cross Blue View Vision. Vision care is not available on campus. However, there are many vision care providers available in the community.

 

Customer Service: (866) 940-8306

www.ucop.edu/ucship

 

Dental Benefits (PDF)

Delta Dental is the dental insurance provider through University of California Student Health Insurance Plan (UC SHIP). The Student Health Center (SHC) dentists are part of Delta Dental Preferred Provider Network. The SHC Dental Clinic is conveniently located on campus.

 

Customer Service: (800) 765-6003

www.ucop.edu/ucship

 

Pharmacy Benefits (PDF)

Pharmacy Directory (PDF)

Pharmacy Home Delivery (PDF)

Pharmacy Home Delivery Order Form (PDF)

 

Nurseline (PDF)

Available for all SHIP members when the Student Health Center is closed. (Nurseline Flyer)

Summary of PPO Networks available for USHIP (Undergraduates):

  • Medical            =            CIGNA
  • Dental               =            Delta Dental
  • Vision               =            Anthem Blue Cross “Blue View Vision”
  • Pharmacy          =            CIGNA

Dependents of Undergraduates (PDF)
Covered undergraduate students may also enroll their eligible Dependents. For more information on the Dependent plan, please visit www.4studenthealth.com/uci. For questions about Dependent enrollment, please contact Ascension at (800) 537-1777.

 

 

 

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Graduate Student Health Insurance Plan (GSHIP)

 

GSHIP UC Family Provider Directory (PDF)

 

Welcome to UC SHIP! (PDF)

 

Key 2014-2015 plan changes (PDF)

 

University of California Student Health Insurance Plan (UC SHIP) is the University sponsored health insurance program for graduate students. Eligible students are automatically enrolled in UC SHIP and the premium for this insurance is assessed each term on the graduate student's registration fee statement. You may request to waive out of this plan if you can demonstrate comparable and verifiable health coverage that meets the campus' minimum standards for insurance.

 

UC SHIP is a comprehensive health plan that provides medical, mental health care, pharmacy, vision and dental coverage. It features year-round, world-wide coverage using the Anthem Blue Cross PPO network. UC SHIP provides optimal coverage for services on campus and in the UC Irvine community, and peace of mind for both parents and students.

 

UC SHIP members receive their primary care at the Student Health Center, where treatment will be administered or, if necessary, a referral issued. Please note that, although the UC SHIP plan is technically a PPO-type plan, students must first obtain a referral authorization from a Student Health Center primary care provider BEFORE seeking treatment from a non-SHC provider. If a referral authorization is not obtained in advance for any outside services other than emergency care or mental health care, then the claim will be denied.

 

The University of California Student Health Insurance Plan (UC SHIP) includes the following:

 

Medical Benefits (Summary of Benefits) (Brochure)

The medical benefits of the plan are provided through Anthem Blue Cross. For more information please visit the Anthem Blue Cross web site at www.ucop.edu/ucship.

 

Customer Service: (866) 940-8306

 

 

Behavioral Health Benefits

Your mental health network of providers is Behavioral Health Network. Mental health services are provided on campus or you may seek treatment from a network provider in the community.

Customer Service: (866) 940-8306

www.ucop.edu/ucship

 

Vision Benefits Summary(PDF)

Your Vision benefits are provided through Anthem Blue Cross Blue View Vision. Vision care is not available on campus. However, there are many vision care providers available in the community. To find a provider, please click on this link.

 

Customer Service: (866) 940-8306

www.ucop.edu/ucship

 

Dental Benefits Summary(PDF)

Delta Dental is the dental insurance provider for UC SHIP students. The Student Health Center Dental Clinic is staffed by Delta Dental PPO dentists and is conveniently located on campus. UC SHIP members can also select from a wide choice of local dentists, listed on the Delta Dental website at www.deltadentalins.com/ucship or www.ucop.edu/ucship.

 

Customer Service: (800) 765-6003

 

Pharmacy Benefits (PDF)

Ventegra Member Letter

Claim Form (PDF)

BIN: 012528

PCN: VENTEG

Customer Service #: 877-867-0943

 

Nurseline (PDF)

Toll-free number: (877) 351-3457

Available for all SHIP members when the Student Health Center is closed.

 

Summary of PPO Networks available for GSHIP (Graduates):

 

  • Medical             =            Anthem Blue Cross Prudent Buyer
  • Dental               =            Delta Dental
  • Vision                =            Anthem Blue Cross “Blue View Vision”
  • Pharmacy          =            Ventegra

 

UC SHIP & Healthcare Reform

 

  • How Does UC SHIP Compare to Covered CA Health Plans? (PDF)
  • Five things you need to know about the Affordable Care Act and UC SHIP (PDF)
  • What does the Affordable Care Act (ACA) mean for me and my family? (PDF)
  • Glossary of ACA and Insurance Terms (PDF)

Coverage Periods for Academic Year 2015-2016 :

   
Start
 
End
         
Undergraduates        
Fall  
09/21/2015
 
01/03/2016
Winter  
01/04/2016
 
03/22/2016
Spring/Summer  
03/23/2016
 
09/18/2016
         
Graduates        
Fall  
09/21/2015
 
01/03/2016
Winter  
01/04/2016
 
03/22/2016
Spring/Summer  
03/23/2016
 
09/18/2016
         
Medical - First Year, Transfer, Returning        
Fall  
08/03/2015
01/03/2016
Winter  
01/04/2016
03/22/2016
Spring/Summer  
03/23/2016
09/18/2016
         
Medical - Continuing        
Fall  
09/21/2015
 
01/03/2016
Winter  
01/04/2016
 
03/22/2016
Spring/Summer  
03/23/2016
 
09/18/2016
         
Law - First Year, Transfer, Returning        
Fall  
08/12/2015
01/03/2016
Spring/Summer  
01/04/2016
09/18/2016
         
Law - Continuing        
Fall  
09/21/2015
01/03/2016
Spring/Summer  
01/04/2016
09/18/2016
         
         
         

 

 

 

 

 

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How to use SHIP

Here are the basics to get you started:

When you need health care:

With SHIP, all care must begin at Student Health Center (SHC). When you need medical care, there are three ways to make an appointment:

  • By telephone at (949) 824-5304
  • In person at the SHC Front Office
  • Online at www.shc.uci.edu
There are no claims to file for SHC visits.

Referrals from SHC clinicians

If necessary, the SHC physician will provide you with a referral for specialty care treatment that is not offered at the SHC. You must have outside appointments pre-authorized by the Insurance Office. Off-campus care (care outside of UCI SHC) is coordinated by SHC clinicians, and the Insurance Office staff will provide referral authorizations for covered services to ensure that your claims are handled accurately.

 

For off-campus care, UC SHIP contracts with Anthem Blue Cross (Graduate students) and Cigna (undergraduate students) to provide medical and mental health services through their extensive network of hospitals and providers. If providers or facilities are used that are not part of the Anthem Blue Cross Prudent Buyer Provider Network (Graduate students) or Cigna preferred provider network (Undergraduate students), then your claims will be paid at a percentage of the "limited fee schedule”. These rates are often significantly lower than the network rate and could result in a higher out-of-pocket cost to you. To find an Anthem Blue Cross Prudent Buyer or Cigna provider you can call the customer service number on the back of your health insurance card.

Emergency care

No referral/authorization from the Student Health Insurance Office is required for visits to an emergency room or urgent care center. Please provide the facility with your insurance card. Students must return to the SHC for all follow-up treatment.

Pre-existing conditions

SHIP does not exclude pre-existing conditions. There is no waiting period for coverage for pre-existing conditions.

Authorization for Services

All non-emergency services provided outside of SHC must receive prior authorization from SHC or your claim will be denied.

Some of the services outside SHC that do not require pre-authorization/referral include:

  • Services provided in a hospital emergency room or urgent care center for treatment of a sudden, serious or acute injury, illness or condition
  • Prescriptions filled outside of SHC
  • Services provided under the dental coverage or vision services coverage

Billing for services at SHC

At the time of service, patients will pay only the fees for which they are responsible (e.g., co-pay for office visit and pharmacy; coinsurance for lab tests and x-rays). SHC will then file a claim with Anthem Blue Cross (graduate) and PIA (undergraduate) for payment of the remainder of the covered charges.

Billing for services outside SHC

When students receive care outside of Student Health Center, the health care provider may require the co-payment and/or coinsurance at the time of service, or they may send a bill after the insurance company has paid the covered amount. Most providers will submit bills directly to the insurance company. If a student receives a bill for the full cost of services, the student should contact Anthem Blue Cross (graduate) or PIA (undergraduate) for assistance. For questions about claims or the Explanation of Benefits, graduate students may call Anthem Blue Cross at 866-940-8306. Undergraduate students may call PIA at 855-515-2423.

 

For out of state claims for graduate students: When you are outside of California and receive health care services, you should request that your provider bill the local Blue Cross - Blue Shield company in that state to ensure that your services are covered according to your UC SHIP benefits.


For out of country claims: Be sure to obtain a bill that contains all of the information listed below. For graduate students, you can print and use an "international claim form" from the BlueCard® Worldwide website. For undergraduate students, call FrontierMEDEX Service Center collect at 410-453-6330 24/7 for more information.

 

To ensure proper payment or reimbursement of your claim, make sure that you receive an itemized bill from the provider. An itemized bill includes:

  • Provider’s name, address, and tax identification number. Individual providers must also include their professional license number.
  • Patient’s name, address, date of birth, and your insurance number.
  • Dates of service.
  • Procedure codes for service rendered.
  • Charges for each service.
  • Date of injury and description of how the injury occurred, if the claim is for treatment of an injury. This is especially important on claims for dental injury.
If any of this information is not included on a claim, the insurance payment may be delayed or denied. Most providers are aware of what is required for processing an insurance claim and will be happy to exchange an incomplete bill with one containing all of the required information.

Deductibles

Undergraduate Students:

There is a $300 in-network plan year deductible for most services provided outside SHC. SHIP members are responsible for the first $300 of charges each plan year. Once the deductible has been satisfied, SHIP benefits begin. Amounts over the "limited fee schedule" as determined by SHIP do not accumulate toward the deductible. If services are received at SHC, then the deductible is waived.

 

Graduate Students:

  There is a $300 in-network plan year deductible for most services provided outside SHC. SHIP members are responsible for the first $300 of charges each plan year. Once the deductible has been satisfied, SHIP benefits begin. Amounts over the "limited fee schedule" as determined by SHIP do not accumulate toward the deductible. If services are received at SHC or at a UC Medical Center, then the deductible is waived. The out-of-network deductible is $500.00.

Dual coverage

Services provided at SHC will be billed exclusively to Anthem Blue Cross (graduate) and PIA (undergraduate) regardless of whether you have dual coverage through another plan in addition to SHIP. For services provided outside of SHC, SHIP is secondary to all other insurance plans, (except Medi-Cal, TriCare, and MRMIP) meaning the other plan must pay for services first. In this case, SHIP will cover any charges, within the plan's benefit limits, not covered by your other plan. In order to coordinate coverage and payment, Anthem Blue Cross or PIA may ask you for information about your other plan.

Annual out-of-pocket maximum

Undergraduate Students:

Students are responsible for no more than $3,000 of out-of-pocket in-network expenses each plan year. If you have paid $3,000 in co-insurance (excluding deductible and copayments), you will no longer be required to pay co-insurance for the remainder of the plan year, but you remain responsible for co-payments and costs in excess of covered expense. The out-of-pocket maximum for out-of-network expenses is $6,000.

 

Graduate Students:

Students are responsible for no more than $3,000 of out-of-pocket in-network expenses each plan year. If you have paid $3,000 in co-insurance (excluding deductible and copayments), you will no longer be required to pay co-insurance for the remainder of the plan year, but you remain responsible for co-payments and costs in excess of covered expense. The out-of-pocket maximum for out-of-network expenses is $6,000. The out-of-pocket maximum expense is limited to $2,000.00 if the student utilizes a UC Medical Center.

Lifetime maximum

UC SHIP has no lifetime maximum.

Managing your plan

Updated address: It is very important that you keep your address updated with the Office of the Registrar as this is the same address that SHIP utilizes. When you move or go away for the summer, please remember to update your address with the Office of the Registrar at http://www.reg.uci.edu/request/changeaddress.html.

 

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Cost of SHIP

 

SHIP Fees for 2015-2016 Academic Year

Includes: Medical, Behavioral Health, Pharmacy, Vision & Dental

 

Per Term

Annual

Undergraduates

$1,497.00

Fall

$499.00

Winter

$499.00

Spring/Summer

$499.00

Graduates  

$3,484.00

Fall

$1,162.00

Winter

$1,161.00

Spring/Summer   $1,161.00    
         
Medical - First Year, Transfer,        
Returning       $3,942.00
Fall   $1,620.00    
Winter   $1,161.00    
Spring/Summer   $1,161.00    
         
Medical - Continuing       $3,484.00
Fall  

$1,162.00

   
Winter  

$1,161.00

   
Spring/Summer   $1,161.00    
         
Law - First Year, Transfer, Returning       $3,856.00
Fall   $2,114.00    
Spring/Summer   $1,742.00    
         
Law - Continuing       $3,484.00
Fall   $1,742.00    
Spring/Summer   $1,742.00    

 

 

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SHIP Enrollment

 

Who May Enroll

 

Students are automatically enrolled in the Student Health Insurance Plan (SHIP), if charged a health insurance fee on their registration bill.

 

 

Eligibility for SHIP includes:

  • All registered undergraduate and graduate students of the Irvine campus at the University of California, including registered international students that are assessed the USHIP/GSHIP fee.
  • All graduate students who are registered-in-absentia.

 

How to Enroll

 

Eligible registered students are automatically enrolled in SHIP. The health insurance fee is billed as part of students' registration fees. Note: Students can request to waive enrollment with proof of comparable insurance and receive a refund for the SHIP fee. Waivers must be filed by the deadline dates shown in the section entitled “Waiving Student Health Insurance Plan (SHIP)”.

 

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Voluntary Enrollment for Graduate Students

 

Voluntary enrollment for Graduate Students in UC SHIP is managed by Wells Fargo Insurance Services (on behalf of Anthem Blue Cross). In addition, the cost of insurance premiums for voluntary enrollment is paid directly to Wells Fargo Insurance Services.

 

The following groups may purchase plan coverage through Wells Fargo Insurance Services at 800-853-5899.

 

EMBA | HCEMBA | FEMBA (PDF)

MPAC (PDF)

First Summer GSHIP (PDF)

Summer Med (PDF)

 

Approved Filing Fee Status

 

  • All non-registered students on approved “Filing Fee Status” who are completing work under the auspices of the University of California, but are not attending classes. Filing Fee students are allowed to purchase UC SHIP for a maximum of one semester/quarter. The student must have been covered by the plan in the term immediately preceding the term the student wants to purchase, or, if the student waived enrollment in the prior coverage period, show proof of the plan used to waive. (PDF)

 

Approved Leave of Absence

  • All non-registered students on approved “Leave of Absence”. These students are allowed to purchase UC SHIP for a maximum of one semester or two quarters. The student must have been covered by the plan in the term immediately preceding the term the student wants to purchase, or, if the student waived enrollment in the prior coverage period, show proof of the plan used to waive. (PDF)

 

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Dependent Enrollment

 

Coverage of eligible dependents will not be effective prior to that of the insured student or extended beyond that of the insured student. Dependent enrollment or re-enrollment in the plan is not automatic. Eligible dependents must be re-enrolled in each subsequent term in order to continue coverage under the dependent plan. If a student decides to disenroll their dependent(s) during an academic term, then the premiums are non-refundable..

 

Graduate Students

 

All graduate students who are enrolled in UC SHIP have the option to enroll eligible dependents in a voluntary plan. The plan provides medical insurance and the option to add dental and vision benefits. NOTE: If both student parents are covered by SHIP, their children may be covered as the dependents of either student, but not both.

 

Enrollment in the dependent plan is managed by Wells Fargo Insurance Services (on behalf of Anthem Blue Cross) and the cost of the dependent premiums is payable directly to Wells Fargo. For dependent plan enrollment questions, please call Wells Fargo Insurance Services customer services at 800-853-5899.

 

Links to Dependent Plan Benefits: Coming Soon

 

Dependent Eligibility & Documentation (PDF)

 

Documentation

 

Students are required to provide proof of dependent status when enrolling their dependents in the plan. The following documents are acceptable:

  • Spouse - marriage certificate
  • Same-Sex Domestic Partner - a Declaration of Domestic partnership issued by the State of California, or of same-sex legal union other than marriage formed in another jurisdiction, or a completed declaration of Domestic Partnership Form issued by the University
  • Natural Child - a birth certificate showing the student is the parent of the child
  • Stepchild - a birth certificate and a marriage certificate showing that one of the parents listed in the birth certificate is married to the student
  • Adopted or Foster Child - documentation from the placement agency showing that the student has the legal right to control the child's health care

 

Enrollment Forms

 

 

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Health Insurance After Graduation (Graduate and Undergraduate)

 

If you are a SHIP member who will be graduating this term, a variety of plans are available for you to purchase directly through Anthem Blue Cross (graduate students) or through Ascension (the insurance broker for undergraduate students’ SHIP plan) once your SHIP coverage expires. Plan types include:

  • Conversion plan (Graduate Students) – guaranteed issue for persons with ongoing medical conditions. (PDF)

 

For graduate students, please visit Anthem Blue Cross website at: http://www.anthem.com/ca

For undergraduate students, please visit Ascension website at: www.4studenthealth.com/uci

 

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Waiving Student Health Insurance Plan (SHIP)

All eligible graduate and undergraduate students at UC Irvine are automatically enrolled in SHIP and charged a health insurance fee as part of registration at UC Irvine. If you are currently covered by major medical health insurance that is comparable to SHIP, you may request to waive out of the plan.

 

Wells Fargo Online Waiver

 

Important Notice to UC Irvine undergraduate students studying abroad through the Education Abroad Program (EAP):

 

Effective with the 2015-2016 academic year, EAP students must maintain their domestic health insurance coverage in order to be compliant with the Minimum Essential Coverage (MEC) requirements mandated by the Affordable Care Act. The travel insurance policy administered through EAP does not qualify as an MEC-compliant plan. Therefore, EAP students, as with all registered students, will be automatically enrolled in SHIP and are responsible for paying the SHIP insurance premium to UCI by the UCI Fee Payment Deadline for each quarter unless they waive out of SHIP successfully by the waiver application deadline. EAP students, as with all registered students, will not be able to waive out of SHIP successfully unless they are covered under another domestic MEC-compliant health insurance plan that also meets the SHIP waiver criteria. Students should contact their EAP Advisor at 949-824-6343 for questions specific to EAP or SHC's Insurance Services Department at 949-824-2388 for questions pertaining to SHIP coverage, benefits and/or the waiver application process.

 

To waive out of the UC Irvine sponsored health insurance plan for 2015-2016, you must submit a request on-line during the open waiver period in the table below. If approved, the waiver is in effect for the current term and the remainder of the academic year. A new waiver request must be submitted at the beginning of each academic year.

 

Waiver Schedules for 2015-2016

Quarter

Begin

End

Fall

06/22/2015

09/11/2015

Winter

11/02/2015

12/11/2015

Spring/Summer

02/01/2016

03/11/2016

 

Semester

 

Begin

 

End

Fall

06/22/2015

09/11/2015

Spring

11/02/2015

12/11/2015

 

* Fall Quarter waiver period start date has been changed from 6-1-2015 to 6-22-2015. *

 

On-Line Waiver Information for Undergraduate and Graduate Students

Waiver Criteria Change Statement 2015_2016 Oct 29 2014

 

The UC SHIP waiver criteria are listed below. They were revised in October, 2014 and are applicable to the 2015-2016 academic year. 

 

To satisfy UC’s health insurance requirement for enrolled students, the plan held by the student must:

 

1.) Be a Medi-Cal, Medicare or Tricare/military insurance policy or a Covered California plan

 

OR

 

2.) Be an employer-sponsored group health plan or individual plan that meets the following criteria:

a.) Has unlimited lifetime benefits

 

b.) Has an annual out-of-pocket maximum of up to $6,600 for an individual but no more than $13,200 for a family. Deductibles, copayments and coinsurance paid by the member accrue toward meeting the out-of-pocket maximum. A higher out-of-pocket maximum is allowed if the subscriber has a Health Savings Account (HSA) or a Health Reimbursement Account (HRA)

 

c.) Covers the following services (ACA Essential Health Benefits):

 

i.) Preventive health care services, including an annual physical exam, preventative immunizations and laboratory/diagnostic tests to help determine your state of health

 

ii.) Chronic disease management for such conditions as asthma, diabetes or other chronic medical conditions

 

iii.) Hospital stays for medical and surgical care

 

iv.) Hospital stays for mental health and alcohol/drug abuse conditions, covered the same as any other medical condition

 

v.) Doctor office visits for medical, mental health, and alcohol/drug abuse conditions

 

vi.) Emergency room services

 

vii.) Diagnostic services including laboratory tests

 

viii.) Medications prescribed by a doctor (including contraceptives)

 

ix.) Pre-natal and maternity care, with no pre-existing condition limitation

 

 

3.) For international students, the following additional criteria apply. The plan must:

 

a.) Have no pre-existing condition exclusion; if the plan has a pre-existing condition waiting period, that period has expired

 

b.) Have no per-injury or per-illness maximum benefit limits

 

c.) Cover medical services for injury from participation in all types of recreational activities or amateur sports

 

d.) Not be a health care reimbursement arrangement with the student’s home country or another party.

 

e.) Have policy written in standard English with benefits expressed in U.S. dollars

 

f.) Have a claims payment office with an address in the United States

 

g.) Pay at least $50,000 annually for medical evacuation

 

h.) Pay at least $25,000 for repatriation of remains

 

4.) For all students, all plans must provide unrestricted access to an in-network hospital or doctor providing full, non-emergency medical and behavioral health care within 50 miles of the UC Irvine campus or the student’s place of residence while attending school. NOTE: this criterion applies to all plan types, including Covered California plans.

 

5.) Travel plans are not allowed to be used to waive participation in SHIP.

 

If you have any questions regarding the SHIP Waiver criteria, please call or email the SHC Insurance Office at 949-824-2388; shc-insurance@uci.edu; or stop by the Insurance Office at the Student Health Center between the hours of 9:00 AM and 4:00 PM, Monday through Friday.

 

Wells Fargo Online Waiver

 

IMPORTANT! You can submit the waiver request ONE TIME ONLY. Once the waiver has been submitted you will receive a “Waiver Accepted” or “Waiver Denied” response based on the answers provided on the waiver form. You will NOT be able to access the waiver system again to make any corrections, so it is important that you have all of the correct information in advance of submitting the waiver.

 

Please use the waiver worksheet to help gather your plan information and other requested information BEFORE you begin your online waiver application to complete all the questions quickly and accurately.

 

If you don't know the answers to the questions, please call the Member or Customer Service number on your insurance card for assistance. Most plan information can be found in your plan benefit booklet, benefits summary, contract, or policy, or check the carrier’s website the health information to find the details of your plan. Incorrect answers could result in delay or denial of your waiver application. When you are ready to go on-line to waive, please remember to print a page of the waiver acceptance/denial page. The Insurance Office will not accept waiver requests past the posted deadlines and does not accept waiver requests in paper format.

 

Please submit your waiver application as soon as possible. If you wait until the last minute, you risk running into an overloaded computer system.

 

Your insurance coverage will be compared to SHIP guidelines and a waiver will be granted or denied based upon the comparison.

 

If you submit a waiver request online, you will receive an instantaneous response. The last screen of the on-line waiver application process will provide you with approval or denial information. You should print this screen for your records. If your waiver has been approved, fees will be reversed and reflected on the student’s account within ten (10) business days.

 

You may also check your SHIP waiver status on Zot Account Online. (If you pay your fees before you have been notified that you have been granted a waiver, be sure you pay the entire fee amount. If you deduct the health insurance amount from the amount of fees you pay and your waiver request is denied, you risk having your classes dropped unless you pay the remainder of the fee before the registration fee deadline.)

 

 

SHIP Appeal of Waiver Denial Form

 

If your waiver application has been denied due to inaccurate or incomplete information or because your existing health insurance does not meet all of the waiver criteria, you may complete and submit the Waiver Appeal Form, including supporting documents, to the SHC Insurance Office. The “Appeal of Waiver Denial” must be received within 10 business days of your waiver denial. AS SUPPORTING DOCUMENTATION, DO NOT SEND YOUR ENTIRE PLAN BOOKLET! PLEASE SEND A SUMMARY OF BENEFITS ONLY AND A COPY OF THE FRONT AND BACK OF YOUR HEALTH INSURANCE ID CARD.

 

SHIP Waiver Reversal Form

 

If you have waived SHIP enrollment and wish to reverse your waiver, you can fill out a Waiver Reversal Form and submit the completed form to SHC Insurance Office during the enrollment period.

 

Also, if you lose your private insurance between terms, you can purchase SHIP at the full cost of the term. An official Letter of Termination/Loss of Coverage from your previous health insurance carrier must be submitted to the SHC Insurance Office to initiate the enrollment process. Your effective date of coverage will be the day following completion of the waiver reversal form and documentation of your loss of coverage.  Please note: UC SHIP policy states that students who waive UC SHIP must notify the Student Health Center no later than 30 days following the date that the student lost the coverage that they used to waive out of UC SHIP.  If the student has no other coverage, then they will be enrolled in UC SHIP at that time and pay the premium for the entire term.  Maintaining health care insurance at all times that meets UC's minimum requirements is a condition of enrollment at UC.

 

Student Health Center Insurance Office Contact Information:

 

Phone: (949) 824-2388
Fax: (949) 824-5062

E-mail: shc-insurance@uci.edu

Address:
UC Irvine Student Health Insurance Office
501 Student Health
Irvine, CA 92697-5200

 

Regular Office Hours
Monday-Friday: 9:00 am-4:00pm

 

 

Waiver FAQ

If you want to waive participation in the Student Health Insurance Plan, then you must complete and submit an Online Waiver Application no later than 11:59 p.m. on September 11, 2015 for the FALL term, or no later than 11:59 p.m. on December 11, 2015 for the WINTER term, or no later than 11:59 p.m. on March 11, 2016 for the SPRING term.

The insurance policy covering the student must provide benefits comparable to the University’s guidelines. An “approved” confirmation notice or a “denied” statement is presented after you submit the waiver. You should print this notice for your records.

 

Yes. Your approved waiver is effective for the current academic term only. If you want to waive participation for the next academic year, you must file another waiver application.

 

Waiver applications may be completed and submitted online at https://studentinsurance.wellsfargo.com/waivers/OnlineWaiver.aspx?pagetype=AUTH&waivername=uci

 

You will need information about your health insurance plan, including the company name and phone number, group number, the student’s policy identification number, the policy holder’s relationship to the student, and the summary of benefits.  Please use the waiver worksheet (PDF) to gather this information in advance of using the online waiver application.

 

You have several useful sources of information to help you complete your waiver application. First, you can refer to the Evidence of Coverage booklet. The booklet is provided by your insurance company and describes all of your benefits and the limitations of those benefits. If you cannot find your booklet, you may find it on the insurance company’s website or call the customer service number on your insurance card and ask for assistance.

 

If you submitted a waiver application online, then you will receive an instantaneous response. The last screen of the online waiver application process will provide you with approval or denial information. You should print this screen for your records.

 

If your waiver application is denied because your private insurance benefits are not sufficient, you may appeal the denial by submitting an “Appeal of Waiver Denial” form, which you can download here and which is also available at the Student Health Center Web Site at www.shc.uci.edu. Completed appeal applications must be received within ten (10) calendar days from the date of denial. Appeals for denied waiver applications are accepted only for the current term. Retroactive appeals are not accepted. Incomplete appeal applications will not be considered for review.

 

You are required to maintain comparable health insurance at all times during your approved waiver period. If your health insurance coverage is terminated during the waiver period, you are required to enroll in the Student Health Plan. To enroll in the plan you must submit a Waiver Reversal Form to the UC Irvine Insurance Office immediately. UC Irvine Student Health Plan coverage will be effective in the term specified on the form. Your student account will be billed.

 

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