Becker College

STUDENT ACCIDENT & SICKNESS INSURANCE PROGRAM
2010-2011 Policy Year

Before You Begin Your Waiver Form

Massachusetts Law requires that all students enrolled in at least 3/4 of full time credits need to be enrolled in a health insurance plan while attending college. At Becker College all students enrolled in at least 9 credits are automatically enrolled in the Student Accident and Sickness Plan.

If a student can provide evidence of other comparable coverage by completing the online Waiver Form, he/she will not be required to enroll in the Student Accident & Sickness Insurance Plan.

All students taking 9 or more credits who wish to waive the Student Accident & Sickness Insurance Plan need to give notice of their decision by completing the appropriate online Waiver Form. The Student Accident and Sickness Insurance Plan can be waived if your current health insurance plan provides comparable coverage. Free Care is not considered comparable coverage. In order to make that decision, be sure your current health insurance plan will provide you with adequate coverage that is accessible in the Leicester/Worcester area:

• Lab tests and x-rays
• Prescription drugs
• Hospitalization (including room and board, physician’s fees, and surgical expenses)
• Outpatient hospital services
• Mental health care
• Emergency room care

If you’re confident that your current health insurance plan meets or exceeds the benefits available through the Student Accident and Sickness Insurance Plan, you can waive the coverage. In order to waive coverage, make sure you have a copy of your current health insurance card, as this card contains the information you’ll need to waive the insurance plan:

• Name of your Insurance Company
• Claims Street Address/PO Box
• Telephone Number (800# preferred)
• Group Name or Group Number (if applicable)
• Name of Policyholder
• Policy ID Number

You will not be able to submit the waiver form if it is not completely filled-out. So make sure you have all of your information ready before you begin.

You cannot waive coverage in the Mandatory Accident Only Plan.

Upon submitting the waiver form, you will immediately receive a confirmation number that your form has been successfully submitted. Please retain this information. If you do not receive a confirmation number, your form was not successfully submitted and you will need to correct any errors and re-submit the form.

Waiver forms must be resubmitted each academic year. A waiver form that was submitted for a prior academic year will not be automatically applied to subsequent academic years. If you are eligible for the Student Accident & Sickness Insurance Plan and do not submit a waiver form this year by the deadline, you will be enrolled in and charged for the insurance plan.