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Health Insurance Waiver Process

Introduction

Students who are required to have health insurance per University policy must enroll in, and pay the premiums for, the student health plan. Students may be able to waive (decline) the plan if covered under another comparable health insurance plan and are eligible to waive (decline) the student health plan (international student athletes may not waive the student health plan regardless of any other insurance coverage they may have).

For 2015-16, in order to waive (decline) the student health plan, you will need to successfully complete the new online waiver process.  

The process consists of answering questions about your current health insurance coverage to see if it qualifies as a comparable plan, as well as the waiver process itself, which includes entering contact and insurance information. 

Questions you will be asked about your insurance

Students will need to answer a number of questions depending on their student status.

Questions for all students completing the waiver process

  1. Are you required to have insurance? See requirement information for clarification on who is required to have insurance.  If you are not required to have insurance, you are not required to waive (decline) the student health plan.
  2. Do you have an out-of-state Medicaid or state subsidized plan?  Medicaid or state subsidized plans outside of Pennsylvania are not comparable coverage.
  3. Do you have Tricare, Medicare or equivalent program coverage? If you are a student athlete or dance/theatre major, this is not comparable coverage.
  4. Are you covered from Aug. 1, 2015, to July 31, 2016? 
  5. Do you have access to doctors, specialists, hospitals and other health care providers in emergency and non-emergency situations in the Pittsburgh area?
  6. Do you have coverage for inpatient hospital services in the Pittsburgh area?
  7. Do you have coverage for diagnostic services such as laboratory/pathology, X-rays, MRI/CT scans, etc., physical therapy and chiropractic care, emergency room treatment, ambulance services and prescription medicines in the Pittsburgh area?
  8. Do you have coverage for inpatient and outpatient mental health, substance abuse and counseling services in the Pittsburgh area?

Questions for international students

  1. International student athletes may not waive (decline) the student health plan, regardless of any other insurance coverage you may have. You must enroll in, and pay the premiums for, the student health plan. See How to Enroll.
  2. For all other international students, is your insurance plan based in the United States? Plans based in a U.S. territory (Guam, Virgin Islands, Puerto Rico) are not comparable and cannot be used to waive (decline) the student health plan.

Questions for student athletes (including cheerleading)

  1. International student athletes may not waive (decline) the student health plan, regardless of any other insurance coverage you may have. You must enroll in, and pay the premiums for, the student health plan. See How to Enroll.
  2. For all other student athletes, do you have in-network and out-of-network coverage for the items referred to in 5-8 above that apply to all students?  Because the University athletic teams travel to locations outside of the Pittsburgh area in the course of competition, it is important to have access to care not only in the Pittsburgh area, but outside of the Pittsburgh area in the event care is needed while traveling with your team.
  3. Does your insurance cover injuries sustained in the practice or play of intercollegiate sports? Not all plans cover this, so it’s important to ask your insurance company if you are not sure.

Additional information for student athletes (including cheerleading) and dance/theatre majors  

If you are injured during practice, play, rehearsal or performance on behalf of the University, you are eligible for the University’s secondary accident insurance coverage.  In this case, your health insurance is primary, and the accident insurance is secondary.  There is a $2,500 deductible per injury for the accident insurance, and depending on your health insurance plan, and the nature of the injury, this may result in out-of-pocket expenses for you.

Additional questions all students will be asked about their insurance, if their plan is determined to be comparable to the student health plan  

This is the part of the process where you actually waive (decline) coverage under the student health plan. You will be asked for general demographic information, such as name, address, etc. Some of this information may be pre-populated; make corrections as necessary. 

Please note that this information is taken from your University record, so any incorrect information here means that your University record is also inaccurate. To update you University record, log in to PointWeb, visit the Change of Address page, or visit the Office of the University Registrar on the 9th floor of Thayer Hall.

You will need your insurance card, or equivalent information, including:

  • Insurance company name and address
  • Insurance company phone numbers:  Member services and preauthorization phone numbers
  • Type of insurance (HMO, PPO, EPO, etc.)
  • Policyholder name and date of birth
  • Student’s relationship to policyholder
  • Policyholder ID #/Member ID #

Important Notes Before Proceeding to the Online Waiver

Before proceeding, you will need to have:

  • Point Park email address
  • Point Park student ID number

You must also be able to access your Point Park email account, as you will be prompted to change your password when first attempting to log in to the site; instructions for doing this will be sent to your Point Park email at that time.

For assistance with Point Park email account issues, contact:

Once you complete the Important Considerations portion of the process, and you demonstrate that you have comparable coverage, and are eligible to waive (decline) the student health plan, you will then be able to proceed to the waiver process. 

When you submit the waiver, you will receive a reference number. This number will be emailed to your Point Park email address. If you entered an alternate (second) email address, it will be emailed there as well.

Submitted waivers are subject to a comprehensive audit process to validate active enrollment and comparable insurance coverage.  Once this audit is complete, you will be notified by email whether the waiver has been accepted.

If the waiver was denied, you will have an additional two times (three times total) to attempt the waiver process.

Students who are unable to successfully complete the waiver process because they are ineligible to waive (decline) must enroll in, and pay the premiums for, the plan; see how to enrollStudents who fail to comply with this policy will be enrolled in the plan by the University and will be required to pay the premiums. The premium cannot be billed to your student account.

Proceed to Online Waiver

(You will be directed to the Gallagher Student Health website)