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Enrollment Forms and Policy Brochures

*Please be sure to review the updated Coverage Periods

 

Summer 2022 Coverage Period

 

Effective Dates of Coverage: 5/1/2022-8/15/2022 (3.5 months of coverage)

Open Enrollment Period: 4/16/2022 -5/27/2022

Deadline to Enroll or Waive: 5/27/2022; Coverage will be backdated to be effective as of 5/1/2022

Premium Amounts:

     Student: $820.00 

     Spouse/Domestic Partner: $820.00

     Child: $820.00

     2 or more Children: $1,640.00 (total)

 


 

NEW Opportunity for Summer Coverage!

 

  • Students not enrolled for Summer semester credit hours are eligible to purchase the Summer coverage period for themselves and their dependents on a voluntary basis
  • Voluntary enrollment requires submission of an Enrollment Form during the designated Open Enrollment period listed above
  • Students not enrolled for any Summer semester credit hours are required to prepay the Summer premium amount(s) to their Student Account prior to the Enrollment Form being processed
  • A prepayment portal is available in the student's My OHIO Student Center in the Financials section
  • Prepayment is not required if the student is enrolled for at least (1) credit hour for Summer semester through any OHIO campus
  • Students enrolled for a minimum of 1 credit hour for Summer semester can enroll in a payment plan for the balance of their Student Account with the Office of the Bursar
Important Note:

Domestic students registered for 5 or more Athens credit hours, and international students registered for 1 or more credit hours, will be automatically charged for the student health insurance upon registration. Please review the webpage for details about automatic enrollment.

 


 

Enrollment Information:

 

  • Domestic students registered for 5 or more Athens credit hours, and international students registered for 1 or more credit hours, will be automatically charged for the student health insurance upon registration. Please review our webpage for details about automatic enrollment.
  • Students automatically charged for the Student Health Insurance do not need to submit an enrollment form
  • Changes to a student's schedule, such as a reduction in credit hours or a class change, may require voluntary enrollment in the student health insurance
  • Be sure to review your student account
  • Voluntary enrollment requires submission of an enrollment form during the designated Open Enrollment period each semester
  • Voluntary enrollment does not automatically continue

 


 

Voluntary Enrollment Form

 

2021/22 Enrollment Form

Voluntary enrollments are processed in the order they are received.

 

Submit pages 1 & 2 of the enrollment form 

 

EMAIL TO:

studentinsurance@ohio.edu 

 

MAIL TO:

OHIO University

Attn: Student Health Insurance

82 South Green Drive

140M Ping Center

Athens, OH, 45701

 

 


 

 

Policy Materials for 2021/22 

*2022/23 Policy materials will be posted as soon as they become available

 

Policy Summary 2021/22  

Provides information regarding annual deductible, coinsurance, copays, policy exclusions, coverage periods, and premium rates.

Full Policy Certificate 2021/22 

Provides detailed information regarding payable benefits for covered services and additional policy information.

TeleHealth Information 

Summary outlining included benefits for virtual services for medical and behavioral health.

MyAccount Directions 

Instructions to create your online account with the insurance company. Access health insurance ID cards, claims and explanation of benefits, personal information, member balances, coordination of benefits, provider locator tools, free resources, and more!

VSP Vision Insurance Summary 

Summary of benefits for the included basic vision insurance package.

 


 

  Policy Out of Pocket Expenses

Detailed Coverage Information is Located in the Policy Summary and Full Policy Certificate.

 

 

       COPAYS

 

 

Provider Appointment, Laboratory, and Radiology at Campus Care (Per Visit)  

$15.00

Office Visit/Appointment with a Network Provider

$25.00

Urgent Care 

$35.00

Emergency Department at a Hospital (waived if admitted to hospital) 

$250.00

 

 

ANNUAL DEDUCTIBLES

 

 

Individual In-Network

$500

Family In-Network

$1,000

Individual Out-of-Network

$5,000

Family Out-of-Network

$10,000

 

OUT OF POCKET MAXIMUMS

 

 

Individual In-Network

$5,000

Family In-Network

$10,000

Individual Out-of-Network

$10,000

Family Out-of-Network

$15,000