The University of Rhode Island
STUDENT HEALTH INSURANCE PLAN
Frequently Asked Questions
GENERAL
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.
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 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. Nationwide, Security Mutual, and MEGA utilize the 80th percentile of R&C for most of its plans.
Can I enroll in the insurance plan after the enrollment deadline?
You can enroll in our plan within 30 days of a qualifying event (loss of other coverage) regardless of our enrollment deadline. You must supply written proof that your other coverage has terminated through a qualifying event.
What is a "pre-existing condition"? How does this affect me as a consumer of health insurance?
A pre-existing condition is any condition for which you have had symptoms or services provided before the effective date on the plan. You must consult your Student Health & Accident brochure or Plan Document to see if there is a clause that limits the coverage of pre-existing conditions.
If I am in a car accident or 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?
Other insurance may be responsible for paying the claim; the services may not be covered according to the exclusions listed in your brochure or Plan Document; the claim may not have occurred while you were covered; or the charges may be over Reasonable and Customary. A letter or explanation of benefits from CHP will accompany any denial of claim.
I have purchased coverage for myself but can I also purchase coverage for my dependents (spouse, child)?
Typically coverage is available. Please refer to your student accident and sickness brochure.
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 “Find a Provider” under Menu. Click on “Find a Provider” 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 consider 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 First Health Network.
How can I check the status of a claim I submitted?
You can check the status of a claim that you have submitted by clicking on the “Claim Status” button under Menu and entering your user id and password.
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.
STUDENT HEALTH
Do I get an insurance card?
Yes. Once you are enrolled in the URI Student Health Insurance, you will get an ID card and a brochure sent to your home.
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?
First of all, please refer to all benefits in your student accident and sickness 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 claim form?
No, passwords are not required to print claim forms. Click on your school on the UHP website, under menu is the claim form that you can download and print out.
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 URI student insurance cover prescription drugs?
No. Your student insurance does not have any prescription coverage.
Does URI student insurance cover dental?
The only dental coverage that you will have is when you need treatment for impacted wisdom teeth and accidental injuries to sound natural teeth.
Does this plan offer any vision benefits?
Yes. The only vision benefit is one annual eye exam.
Does my plan have worldwide coverage?
Yes. If you are sick or get into an accident abroad, please make sure that the bills are translated in English and in U.S. currency so that you can submit it to Consolidated Health Plans for reimbursement.
Please contact University Health Plans at 800-437-6448 to obtain a letter of confirmation of coverage.