Lehigh University
Student Health Insurance Plan
STUDENT WAIVER FORM
2023-2024 POLICY YEAR
All undergraduate matriculating students registered for five (5) or more credits, undergraduate non-matriculating students (non-degree/General College Division) registered for twelve (12) or more credits, graduate students enrolled in a degree seeking on-campus based program and registered for nine (9) or more credits, and Graduate students with certified-full time status registered for (1) or more credits for the Fall 2023 semester are required to show evidence of an existing creditable health insurance policy.
If you already have another health insurance plan that provides comprehensive coverage in the Lehigh area for inpatient and outpatient services in both emergency and non-emergency situations, you may opt out of the Lehigh University Student Health Insurance Plan by submitting this waiver form by the deadline.
All Lehigh International Students on an F-1 or J-1 Visa are not permitted to drop coverage by submitting a waiver form unless you have parents or a spouse/domestic partner living and/or working in the U.S. and are covered under a family plan that's ACA-compliant, you are sponsored to study at Lehigh by your home country or U.S. government that provides you with an insurance plan, or you have dependents at Lehigh and have a private family insurance plan that's ACA-compliant. International students should contact Lehigh’s Office of International Students & Scholars (610) 758-4859 to verify if you qualify for a waiver.
All Lehigh students who are required to have insurance will automatically be charged the associated premium of $2,452 on your student bill. You are strongly encouraged to waive by July 1st to have a credit on your July billing statement.
Once your waiver is completed, please allow 2-3 business days to see the credit posted to your Bursar Account.
Waivers that occur after July 31st, or more than 10 days after becoming eligible, may be subject to a late processing fee of $25.
To continue the waiver process, please fill out the required fields below:
Please note, your LIN# is 9 digits.
***STEP 1 OF 3***
Student Health Plan
- Waiver Form
- Enrollment Form
- Qualifying Event Enrollment Form
-
CareConnect –
Behavioral Health Hotline - Provider Search
- Claim Form
- Insurance ID Card
- Insurance Mobile App
Optional Plans
Additional Information
PLAN CHANGES FOR THE 2016-2017 POLICY YEAR:
UNDERWRITER:
The underwriter for the plan has changed from Nationwide Life Insurance Company to National Guardian Life Insurance Company. Claims are still submitted to Cigna and, subsequently, processed by Consolidated Health Plans (CHP).
DEDUCTIBLE:
There is now only one in-network deductible of $50 and one out-of-network deductible of $50 per policy year, regardless of how many conditions are treated. If the deductible is applicable for a medical service, it can be waived by receiving a referral from the Health and Wellness Center.
REFERRAL:
A referral from the Health and Wellness Center is not required for the 2016-17 policy year. A Health and Wellness Center referral may be used to waive the deductible, if applicable, for a medical service.
COINSURANCE:
Unless stated otherwise in the brochure, the plan will pay at 95% of the Preferred Allowance for in-network services and 85% of Reasonable & Customary Charges for out-of-network services.
OUT-OF-POCKET MAXIMUM:
The out-of-pocket maximum for eligible expenses in-network is $1,500. There is no maximum for out-of-network services.
Lehigh University Qualifying Life Event
Students who waived the Student Health Insurance Plan (SHIP) and recently lost their other coverage or moved to the US can contact the Lehigh Bursar Office at bursar@lehigh.edu to request the qualifying event enrollment form (include your LIN in your email). Once the qualifying event enrollment form has been completed, eligibility will be confirmed, and the insurance charge will be added to the student's account. Once payment has been made to the Lehigh Bursar Office, enrollment will be sent to Wellfleet for processing. If the loss of coverage occurs between 8/15 and 12/31, payment due is the annual premium. If the loss of coverage occurs between 1/1 and 8/14, payment due is the spring premium. The deadline to complete the enrollment form is 60 days from the qualifying life event.