1.

How do I know if I am eligible to enroll in the Student Health Insurance Plan?

All registered students of Sarah Lawrence College are automatically enrolled in the Student Health Insurance Plan.

Students who do not want to be enrolled must submit a completed Waiver Form and provide proof of comparable coverage by July 15, 2022 for the Fall Semester, or by January 6, 2023 for students newly enrolled for Spring Semester. If you do not submit a completed Waiver Form by the waiver deadline date for the term you are enrolling in at Sarah Lawrence College, you will be responsible for the insurance premium posted to your student account.

2.

How do I know if my current coverage is comparable coverage?

For coverage to be comparable, the policy must: be in effect throughout the school year, provide comprehensive coverage of hospital (inpatient and outpatient) and physician services, provide coverage which is accessible to students in the New York area, and be underwritten by a U.S. based insurance carrier (foreign policies are not acceptable).

If you are not sure if your current insurance plan is comparable to the 2022-2023 Sarah Lawrence Student Health Insurance Plan, please determine if you have the following coverage...

• Your coverage may end at age 26. Most health plans have age restrictions that limit coverage for dependents. Under the Student Health Insurance Plan, you’re covered for as long as you are a full-time student.
• You may not be covered outside your State of permanent residency. Many health plans are regionally-based HMO type plans, and will only provide coverage if seen by a specified local provider. The Student Health Insurance Plan provides coverage on a nationwide basis with a comprehensive network of Preferred Providers available.
• You may not be covered abroad. Under the Student Health Insurance Plan, you are covered if you travel in the U.S. or study abroad.
• You may not have coverage for Mental Health or Counseling if your other coverage is just a basic health insurance plan. It is not uncommon for college-age students to need counseling benefits, and the Student Health Insurance Plan provides fairly extensive outpatient and inpatient Mental Health Benefits (please refer to brochure for specific benefits).
• You may not have prescription drug coverage. Under the Student Health Insurance Plan, you pay a low flat fee (co-pay) each time you need to fill a prescription.

3.

What is covered under the Student Health Insurance Plan?

The chart below shows how the Plan pays benefits for the major types of health care expenses. You can see the difference in your cost when you use preferred providers. For more details about Plan benefits, provisions, exclusions, appeals and grievance procedures, disclosure information, and other plan features, be sure to see University Health Plan’s brochure or call them at 833-251-1139 to request a copy of the brochure, or to ask a question specifically about the 2022-2023 Sarah Lawrence College Student Insurance Plan.

4.

Can I go to any health care provider?

You should always be seen at the Sarah Lawrence College Health & Wellness Center when possible to receive the maximum benefits available under the plan. You may see whichever provider you choose, however, if you choose to see a Preferred Provider, the benefits available under the Sarah Lawrence College Student Health Insurance Plan are significantly higher.

Sarah Lawrence College is again accessing the Cigna PPO for the 2022-2023 Plan Year. To find a participating provider, please access the following website:

www.wellfleetstudent.com or www.cigna.com

The doctors and other health care providers who belong to Cigna PPO network are called preferred providers*. They include general practitioners and internists, as well as specialists, hospitals and other health care facilities. Because the network extends across the country, you'll find preferred providers locally as well as nationally.

Remember, using preferred providers saves you money because preferred providers agree to accept negotiated fees that may be lower than what non-preferred providers would charge. Also preferred providers do not charge more than the reasonable charge for a given service. The Plan pays benefits for reasonable charges only. If a non-preferred provider charges more than the reasonable charge allowance, you must pay the difference.

*Preferred providers are independent contractors and are neither employees nor agents of Sarah Lawrence College, University Health Plans, Inc. or Wellfleet New York Insurance Company.

5.

How do I find a Network Provider?

To find a preferred provider on both a local and national basis, please visit:

www.wellfleetstudent.com or www.cigna.com

6.

Do I have to get a referral from Student Health & Wellness Center before seeking treatment elsewhere?

You are not required to receive a referral from the Health & Wellness Center, however, if you do, the benefits payable under the plan are significantly better:

If referred, benefits are paid at 80% PA In-Network and 60% R&C Out-of-Network.

If NOT referred, benefits are paid at 70% PA In-Network and 60% R&C Out-of-Network for Primary Care Office Visits (and Home Visits) and Specialists Office Visits (or Home Visits).

7.

Am I covered for a pre-existing condition?

Yes, benefits are provided for pre-existing conditions on the same basis as any other covered Sickness or Injury.

8.

How do I fill a Prescription?

When obtaining a covered Prescription, please present your insurance ID card at a Wellfleet Rx/ESI participating pharmacy, along with your applicable co-pay. The Pharmacy will bill Wellfleet for the cost of the drug, plus a dispensing fee, less the co-pay amount. Preferred Care Pharmacy locations can found via the following link:

www.wellfleetstudent.com

If you fill your prescription at a non-Wellfleet Rx pharmacy, you may be required to pay out-of-pocket and submit for reimbursement. You can download a claim form at:

https://www.studentinsurance.com/Docs/Resources/4923_Wellfleet-Rx-Reimbursement-Form.pdf​

When submitting a claim, please include all Prescription receipts; indicate that you attend Sarah Lawrence College and include your name, address, and student identification number.

9.

When I receive Medical or Mental Health services, how and where do I submit my bill?

All In-Network provider medical bills should be mailed to:

Cigna
P.O. Box 188061
Chattanooga, TN 37422-8061
Electronic Payor ID: 62308

If you receive treatment from an Out-of-Network provider, you may be required to pay for services out-of-pocket and submit for reimbursement.

Please submit receipts to the following address:

Wellfleet Group, LLC
2077 Roosevelt Avenue
Springfield, MA 01104
Toll Free: 877-657-5030

If you have claims or coverage questions, please contact the Claims Administrator at the following address and phone number:

Wellfleet Group, LLC
2077 Roosevelt Avenue
Springfield, MA 01104
Toll Free: 877-657-5030

Customer Service Representatives are available 8:00 a.m. to 4:30 p.m. (ET), Monday through Friday, for any questions.

• Bills must be submitted within 90 days from the date of treatment.
   
• Payment for Covered Medical Expenses will be made directly to the hospital or Physician concerned unless bill receipts and proof of payment are submitted.
   
• When using a claim form, if itemized medical bills are available at the time the claim form is submitted, attach them to the claim form. Subsequent medical bills should be mailed promptly to the appropriate address listed above.
  
  In the event of a disagreement over the payment of a claim, a written request to review the claim must be mailed to Wellfleet Student within 60 days from the date appearing on the Explanation of Benefits (EOB).

10.

Where and when will ID Cards be distributed?

New for the 2022-2023 plan year, enrollees in the Student Health Insurance Plan will be issued an insurance ID cards via email.  Once enrollment is processed, you will receive an email at your Sarah Lawrence College email address with instructions on how to create an account and download your insurance card pdf.

PLEASE NOTE: STUDENTS WHO DO NOT COMPLETE A WAIVER FORM AND INCUR ANY SERVICES UNDER THE 2022/2023 SARAH LAWRENCE COLLEGE STUDENT HEALTH INSURANCE PLAN, INCLUDING PRESCRIPTION DRUGS, WILL BE RESPONSIBLE FOR THE FULL ANNUAL PREMIUM, AND MAY NOT LATER REQUEST A REFUND OF THE INSURANCE PREMIUM.

This card is for identification only. It is not a guarantee of eligibility or benefits. You do not need an ID card to be eligible to receive benefits.

11.

What if I leave Sarah Lawrence College, will I get a refund?

Except for medical withdrawal due to a covered Accident or Sickness, any student who has not incurred any claims and who withdraws from school during the first 30 days of the period for which coverage is purchased shall not be covered under the Plan and a full refund of premium will be made. Students withdrawing after such waiver deadline date will remain covered under this Plan for the full period for which premium has been paid. No refund will be allowed.

A Covered Person entering the armed forces of any country will not be covered under the Policy as of the date of such entry. A pro-rata refund of premium will be made for such person upon written request received by University Health Plans, Inc. within 90 days of withdrawal from school.

12.

Does this plan cover me when I am off campus during semester breaks or summer vacation?

Yes, the Student Health Insurance Plan provides coverage from August 15, 2022 to August 14, 2023 for students enrolled in the Fall Semester. New Sarah Lawrence College Students enrolling for the Spring Semester will have coverage from January 1, 2023 through August 14, 2023. You will be covered for eligible expenses whether you are on campus or traveling nationwide.

13.

Does the Student Health Insurance Plan cover me if I decide to study abroad?

Yes, the Student Health Insurance Plan provides coverage from August 15, 2022 to August 14, 2023 for students enrolled in the Fall Semester. New Sarah Lawrence College Students enrolling for the Spring Semester will have coverage from January 1, 2023 through August 14, 2023. You will be covered for eligible expenses whether you are on campus or traveling nationwide.

14.

What other plans and services are available to me as an enrolled student in the Student Health Insurance Plan?

The Student Health Insurance Plan is more than comprehensive health coverage. It also offers you these important programs, services, and benefits:

• Emergency Travel Assistance Services
  (Provided by Travel Guard)
  If you have a medical emergency while traveling outside of your home country, you can take advantage of emergency assistance services provided by Travel Guard. These services are available 24 hours a day, 365 days a year and include medical consultation and evaluation, medical referrals, travel advisories and much more.
• Medical Evacuation and Return of Mortal Remains Services
  (Provided by Travel Guard)
  If you need medical care that is not available locally, Travel Guard will provide the transportation, personnel and equipment needed to get you to the nearest facility capable of providing the required care. In the event of your death, Travel Guard will provide assistance in returning your mortal remains.

For more information about the benefits and programs described above, visit the University Health Plans website at www.universityhealthplans.com, and select the link for Sarah Lawrence College.

15.

Who do I contact if I have questions?