Who is Consolidated Health Plans? Who is University Health Plans? What are their roles?
Consolidated Health Plans (CHP) is the claims administrator for the health insurance plan. CHP is responsible for answering questions about insurance benefits, claims, and providing lost ID cards. If you have any questions for CHP, please call 800-633-7867 or email firstname.lastname@example.org. University Health Plans (UHP) is the broker/plan manager who handles the enrollment and waiver process for the school health insurance plan. Please call UHP at 800-437-6448 or email at email@example.com if there are any questions about enrollment and waiver process or if there are customer service issues with CHP.
What is a reasonable and customary charge and how does that charge affect me as a consumer?
Reasonable & Customary charges are guidelines developed by an independent source and used by insurance companies. These guidelines help to assure that the fees providers are charging are reasonable for the service provided in their geographic area.
Can I enroll in the insurance plan after the enrollment deadline?
Yes, you can enroll in our plan within 30 days of a “qualifying event” which results in the loss of other insurance coverage. This must occur while school is in session and you are actively attending classes. Examples of “qualifying events” include: reaching the dependent age limit under a parent's policy, having a newborn, marriage, etc. You must supply written proof that your other coverage has terminated through a “qualifying event”. Contact University Health Plans for enrollment instructions. Please be aware that the premium is not prorated.
Am I covered for a pre-existing condition?
Yes, benefits are provided for pre-existing conditions on the same basis as any other condition.
If I am in a car accident or sustain any other injury, what kind of documents will I need in order to submit a claim form for reimbursement?
You will be asked for a description of the accident, other coverage information and perhaps a police report. A letter from CHP will be sent to you requesting the pertinent information.
What are some of the reasons CHP might not reimburse my medical provider for a claim I submitted?
CHP will send a letter when a claim is denied. The following are common reasons for denial:
I have purchased coverage for myself but can I also purchase coverage for my dependents (spouse, child)?
Yes, you can purchase coverage for your dependents at time of your enrollment. The dependent enrollment form is available on the left hand side of this page. Contact University Health Plans if you have any further enrollment questions.
How can I determine which network I have access to?
Insured’s that have access to a network will have a logo in the upper right-hand corner of the identification card.
Where can I get a directory/list of participating providers and can I find a provider in another state?
Please log onto UHP webpage, click on your school and on the left hand side of the page, you should be able to see “Provider Search” under left Menu. Click on “Provider Search” and you can do a search of providers in various states. If you cannot locate the provider in the directory, then it means that the provider is not part of preferred provider network and is considered out of network.
When scheduling an appointment should I tell the provider's office that I have CHP?
If you are accessing any network other than CHP you should inform the office of that network and ask if they are participating with MagnaCare or MultiPlan.
Can I go to any health care provider?
You may see whatever provider you want, however, if you choose to see a Preferred Provider, the benefits available under the Stevens Student Health Insurance Plan are significantly higher.
MagnaCare is your primary network in NY/NJ. If your provider is not in the MagnaCare Network, then you may also search for providers in the MultiPlan network on a national basis.
To find a MagnaCare provider in the New York/New Jersey area, please go to http://clm.magnacare.com/ProviderLocator/Default.aspx
To find a MultiPlan provider outside the New York/New Jersey area, please go to www.multiplan.com
The doctors and other health care providers who belong to MagnaCare and MultiPlan network are called preferred providers*. They include general practitioners and internists, as well as specialists, hospitals and other health care facilities. Because the MultiPlan 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 Stevens Institute of Technology, University Health Plans, Inc. or National Guardian Life Insurance Company.
How can I check the status of a claim I submitted?
You can check the status of a claim that you have submitted to CHP by visiting their website at https://consolidatedhealthplan.com/members/chps_exclusive_claim_view_access. You must enter your Username and Password to access online-claims status.
What if my password doesn't work?
Passwords are case-sensitive. Please be sure you have entered it exactly as it is printed. If you continue to have a problem please call CHP at 1-800-633-7867.
What is my login?
Your login consists of a user id (member number) and a password. The password is located in the upper right-hand corner of the mailer containing your identification card.
What if I don't know what my password is?
Your password is located in the upper right-hand corner of the mailer containing your identification card.
Do I get an insurance card?
Yes. Once you are enrolled in the Stevens Student Health Insurance, your insurance card will be mailed to the address provided to us by your school.
What if I lost my insurance card?
Please contact CHP at 800-633-7867 to request another card.
Who should I contact for updating my personal information such as a mailing address, name, etc.?
Please call UHP at 800-437-6448 to update your personal information.
If I have a benefit question about my policy, who should I ask?
Please refer to all benefits in your student health insurance brochure. If you still need assistance, please call CHP and a claims administrator can help you with your benefit questions at 800-633-7867.
Do I need a password to print a medical claim form?
No, passwords are not required to print claim forms. To access a claim form, please go to this link https://consolidatedhealthplan.com/files/UpdatedStudentClaimForm2013.pdf.
What happens if I drop out of school while I am enrolled in your insurance plan? Will you refund my money? If not, am I still covered?
You will not receive a refund. However, your plan will continue through the period for which you paid.
Does Stevens Student Insurance cover prescription drugs?
Yes, your student insurance covers prescription drugs. Please see your student health insurance plan brochure for more details.
Which pharmacy can I go to get my prescription?
You can go to any participating pharmacy that is part of the OptumRX Network, such as CVS, Walgreens, Costco, Rite Aid, etc. To find out more about participating pharmacies, please visit this link https://www.universityhealthplans.com/pdf/OptumRx_PharmacyNetwork-1617.pdf.
Does Stevens Student Insurance cover dental?
Members are eligible for some dental services while covered by the Student Health Plan up to the age of 19. Refer to the brochure for details on that Pediatric Dental benefit.
As a member who is 19 years of age or older, the only dental coverage that you will have is when you need treatment for an injury to sound natural teeth.
Does this plan offer any vision benefits?
Members are eligible for some vision services while covered by the Student Health Plan up to the age of 19. Refer to the brochure for details on that Pediatric Vision benefit.
As a member who is 19 years of age or older, the plan provides a vision discount plan. For details, go to www.consolidatedhealthplan.com/student_health and click on the CHP Vision Discount Plan link on the left side.
There is also a voluntary VSP Vision Care Plan that is available to you. The premium for the voluntary vision plan is not included with your Student Health Plan premium. You may enroll in and pay for the VSP Vision Care plan on the UHP website during open enrollment periods. Please see the UHP website for enrollment deadlines and more details. From the UHP home page, select your school and then click on “Voluntary VSP Vision Care Plan”.