Roger Williams University
STUDENT HEALTH INSURANCE PLAN
Qualifying Life Event Enrollment Form
2022-2023 Academic Year
If you have a qualifying life event outlined below, you may qualify for special enrollment rights to enroll in the student insurance plan outside of the initial enrollment period.
Loss of Other Coverage:
Required Documentation:loss of coverage letter that includes your name and your last day of coverage
Deadline:31 days from the last day of coverage in the prior plan
Effective Date of Coverage:the first day without coverage in the prior plan
Change in Residence (entry into the US or moving from coverage area):
Required Documentation:
If moving to the US: Identification page of Passport and page with U.S. entry date stamp
If moving within the US: travel documentation confirming a move to RI and documentation of active insurance coverage that does not provide coverage in RI.
Deadline:31 days from the entry into the US or move from the coverage area
Effective Date of Coverage:date of entry into the US or move out of other plan's service area.
For the 2022-2023 policy year, the prescription drug cost share will change to the following
Tier 1: $15 copay
Tier 2: 20% coinsurance
Tier 3: 20% coinsurance
This change can have an impact on your out-of-pocket costs if you need prescriptions that will require you to pay 20% of the medication's cost up to the plan's $6,350 in-network out-of-pocket maximum (there is no out-of-network out-of-pocket maximum). Before enrolling, we encourage students impacted by the change to compare all other insurance options to the RWU SHIP
Information about the RWU SHIP can be found at www.universityhealthplans.com/rwu. To look up your prescription medication, choose the Prescription Information link on the left. Health Source RI offers information about the RI marketplace where you can compare and purchase insurance plans. You may be eligible for a Subsidized Health Plan (a low or no cost insurance program for qualifying uninsured adults).
For the 2022-2023 policy year, the prescription drug cost share will change to the following
Tier 1: $15 copay
Tier 2: 20% coinsurance
Tier 3: 20% coinsurance
This change can have an impact on your out-of-pocket costs if you need prescriptions that will require you to pay 20% of the medication's cost up to the plan's $6,350 in-network out-of-pocket maximum (there is no out-of-network out-of-pocket maximum). Before enrolling, we encourage students impacted by the change to compare all other insurance options to the RWU SHIP
Information about the RWU SHIP can be found at www.universityhealthplans.com/rwu. To look up your prescription medication, choose the Prescription Information link on the left. Health Source RI offers information about the RI marketplace where you can compare and purchase insurance plans. You may be eligible for a Subsidized Health Plan (a low or no cost insurance program for qualifying uninsured adults).
The 2022-2023 benefits will match the 2021-2022 policy with the following change.
The prescription drug cost share will change to the following:
Tier 1: $15 copay
Tier 2: 20% coinsurance
Tier 3: 20% coinsurance
This change can have an impact on your out-of-pocket costs if you need prescriptions that will require you to pay 20% of the medication's cost up to the plan's $6,350 in-network out-of-pocket maximum (there is no out-of-network out-of-pocket maximum). Before enrolling, we encourage students impacted by the change to compare all other insurance options to the RWU SHIP.
Information about the RWU SHIP can be found at www.universityhealthplans.com/rwu. To look up your prescription medication, choose the Prescription Information link on the left. Health Source RI offers information about the RI marketplace where you can compare and purchase insurance plans. You may be eligible for a Subsidized Health Plan (a low or no cost insurance program for qualifying uninsured adults).