Fitchburg State University
STUDENT HEALTH INSURANCE PLAN

2017-2018 Policy Year

THE WAIVER AND ENROLLMENT FORMS WILL NOT BE AVAILABLE UNTIL JULY 6, 2017 

The Annual Term Waiver Deadline Date is September 30, 2017

In accordance with Massachusetts State Law, Fitchburg State University requires all undergraduate students registered in at least 9 credits and all graduate students registered in at least 4.5 credits to participate in the Student Health Insurance Plan unless proof of comparable coverage is provided. All International students are required to enroll in the Student Health Insurance Plan.

Students with coverage from insurance carriers outside the United States or coverage by foreign National Health Insurance programs may not waive participation in the university’s plan. These plans are not deemed to be comparable to coverage under a QSHIP program. This is a change in the QSHIP regulations that has been mandated by the Division of Health Care Finance and Policy and all institutions are required to comply with this change.

Students must either:

  • Complete the On-Line Enrollment Form.
  • Complete the On-Line Waiver Form.

New and returning students for the Fall, 2017 Semester who fail to complete the on-line enrollment or waiver form will have a hold placed on their student account and will not be able to continue academic advancement until they complete an on-line enrollment or waiver form. As provided by Massachusetts State Law, completion of the on-line enrollment or waiver form is required annually.

Health Safety Net is not considered comparable coverage.

Plan Costs Annual Term Coverage 8/1/17 – 7/31/18
Student Only $2,755

In order to waive coverage, be sure that services covered by your current health insurance plan are reasonably accessible in the Fitchburg area:

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

To complete the Enrollment Form or Waiver Form, select appropriately from the MENU options to the left. When you have completed and successfully submitted the form, you will immediately receive a notice indicating the completion of the form. Please print this notice for your records. If you provide an email address on your form you will also receive an email confirmation.

Please note, if you do not complete a waiver form or enrollment form by the posted deadline date, you will be automatically enrolled in and charged for the Annual Term of the 2017/2018 Student Health Insurance Plan. As stated above, this is Massachusetts State Law.

If you are covered by MassHealth (other than Health Safety Net, MassHealth Limited, or Children’s Medical Security Plan), you may be eligible to enroll in the Student Health Insurance Plan (SHIP) and have the premium paid by MassHealth Premium Assistance. To see if you’re eligible, select the Waiver Form or Enrollment Form link and follow the prompts.