Resources and Forms

Quick Reference Guides

Forms

For more forms, please visit UnitedHealthcare Resources and Forms.

Frequently Asked Questions

For additional questions, visit the United Healthcare FAQ.

Coverage

The plan selected for University System of Georgia is in the UnitedHealthcare Choice Plus network and is in compliance with the Affordable Care Act (ACA) requirements. These are the “preferred providers” who have contracted to provide specific medical care at negotiated prices.
UnitedHealthcare information is available through My Account 24/7.  Listed below are a few of your benefits.

  • Inpatient and Outpatient psychotherapy and alcoholism/drug abuse maximum 30 day visit limit has been eliminated;
  • Ambulance service;
  • Durable medical equipment maximum has been eliminated;
  • Preventative care, well-child care and wellness benefit combined under preventative care, all paid at 100% with no deductible or co-pay.
  • Pharmacy/Prescription drug benefit – Copayment waived for generic prescription medication per 31-day supply; $5 copayment for preferred brand name prescription medication per 31-day supply; $10 copayment for non-preferred brand name. In-Network Coverage Only. Per PPACA, no annual limits except if plan maximum annual limits exceed $100,000.
  • Unlimited medical repatriation and medical evacuation benefits in support of international and domestic travel, except if plan maximum annual limits exceed $100,000.
  • After hour nurse call service and after hour mental health hotline/call service at no additional cost for insured students and family members.
 Coverage begins on August 1 for Fall semester through December 31, 2014.  Spring/Summer is January 1, 2015 through July 31, 2015.
It is limited. Dental is for injury to sound, natural teeth only. Dental benefits are not subject to the $100,000 maximum benefit. Dental does include removal of impacted wisdom teeth. Vision care is covered only as it relates to a disease process. It does not cover eye exams, glasses or contacts.
No. You may see a healthcare provider of your choosing.  The plan pays 80% for in-­network coverage with UnitedHealthcare Choice Plus managed care provider network and 60% for out-­of-network coverage. If you go to the Student Health Clinic and they determine that you should see another physician, a referral will be provided to you.
It is best practice to contact UnitedHealthcare if you plan to see someone other than your primary care physician to determine if a referral is needed from your primary care physician.

Eligibility

All students enrolled for six (6) or more credits per term or participating in Cooperative Education Programs are eligible to enroll in the insurance plan, excluding students that are required to enroll in the plan as stated below. Eligible Dependents of enrolled students may participate in the plan on a voluntary basis.

  • All undergraduate and ESL international students holding F or J visas.
  • All undergraduate students enrolled in programs that require proof of health insurance.
  • All graduate students awarded a Full Tuition Waiver as part of their graduate assistantship award.
  • All graduate international students and visiting scholars holding F or J visas.
  • All graduate students enrolled in programs that require proof of health insurance.
  • All graduate students receiving fellowships fully funding their tuition.

Enrollment

Students in the categories listed below are required to purchase the USG SHIP policy and will be billed on their student account for the respective semester and automatically enrolled in the UHSR insurance unless they waive out of the requirement with equivalent insurance.

  • All undergraduate and ESL international students holding F or J visas.
  • All undergraduate students enrolled in programs that require proof of health insurance.
  • All graduate students awarded a Full Tuition Waiver as part of their graduate assistantship award.
  • All graduate international students and visiting scholars holding F or J visas.
  • All graduate students enrolled in programs that require proof of health insurance.
  • All graduate students receiving fellowships fully funding their tuition.

Students who fall into one of these categories and are actively covered by a comparable insurance policy (i.e. through parents plans, family plans or employer-sponsored plans) may opt out of the plan by  applying for a waiver. Once the insurance information has been verified and approved, a waiver will be processed and a credit posted for the insurance charge to your Georgia State University student account. It may require up to 7 days for waiver approval and processing a credit to your student account.

If you are in the mandatory group to have student health insurance, you will be automatically enrolled in the United Healthcare health insurance after the waiver period ends. If proof of insurance is needed quickly, you should enroll online and print an insurance card.
Confirm with your college that a tuition waiver has been applied to your account. Then, contact Student Accounts at 404-­413-­2600 to verify the tuition waiver was posted to your account and that your name has been sent to UnitedHealthcare.
Insurance charges for students requiring mandatory insurance are posted directly to their student account and payments are made to Georgia State University. Otherwise, students in the non-mandatory group (voluntary) should enroll online using voluntary enrollment form and pay UnitedHealthcare Student Resources directly via credit card or eCheck.
If coverage is purchased for a ‘spring/summer’ period (meaning continuous coverage with no start or stop date for spring and then for summer), no refund will be issued.  You may stay on the plan as long as you meet the eligibility requirements when coverage for spring/summer was purchased.
Mandatory students will need to activate their enrollment online and print a temporary insurance card. You will receive your official insurance card in the mail after the waiver period ends. Activate Enrollment Online

Non-Mandatory (Voluntary) students can access My Account and print their temporary insurance card. Print Temporary Insurance Card 

You will not be charged again for health insurance. UnitedHealthcare will bill Georgia State University for the amount shown on this page. To activate your enrollment, select the checkbox next to: I elect to purchase insurance coverage under this student insurance plan. Above are the choices I have made.* Next, please type first name, middle initial and last name inside Payer Signature box.  Then, click the SUBMIT button. Print Temporary Insurance Card  
If you do not apply for a waiver or if the waiver is declined, you will automatically be enrolled in the plan at the end of the waiver period and you will be mailed an insurance card at that time. The cost of the policy will appear on your student account.

If you need your insurance card prior to the end of the waiver period, you will need to go online and complete the enrollment process yourself. Then, you may print a card immediately and begin using the coverage. Activate Enrollment Online 

Dependents

Dependents can only enroll at the beginning of each respective semester term. However, certain qualifying events allow mandated students and their dependents to enroll outside the end of an enrollment period. Students must elect enrollment within 30 days of the qualifying event.
 Yes, because the arrival of a spouse or child into the country will be considered a qualifying event. You will have 30 days from the date of entry to add the dependent and should pay directly to United Healthcare for spouses and dependents.

Waivers

NOTE: A mandatory health insurance waiver is only valid for one semester, so you will need to submit a new waiver request for each subsequent semester.

UnitedHealthcare Student Resources (UHSR) will verify that the policy you report is in place.  You will need your policy number and name of company and general information about the plan so you can confirm your policy covers the following:

Benefit Requirements for Waivers based on the Affordable Care Act

  • Repatriation of remains in the amount of at least $7,500 (International Only)
  • Medical Evacuation to one’s home country in the amount of at least $10,000 (International Only)
  • Accident and sickness coverage of at least $500,000 per policy year (Domestic)
  • Accident and sickness coverage of at least $200,000 per policy year (International)
  • A deductible not to exceed $3,000 per accident or illness (Domestic)
  • A deductible not to exceed $500 per accident or illness (International)

Find out the waiver dates for each semester. You must be in the “mandatory” group to log into the system which means that you have a full-­time tuition waiver or a F1/J1 visa.
If you answer ‘No’ to either question 1 or question 2 on the Waiver Form, your waiver will get denied.

  1. To your knowledge does your plan cover: repatriation of remains in the amount of at least $7,500, medical evacuation to one’s home country in the amount of at least $10,000, accident and sickness coverage of at least $100,000 per policy year and a deductible not to exceed $500 per accident or illness.
  2. Is your plan in effect for the entire semester?

The University System of Georgia requires students that are waiving out of the mandatory insurance to have health insurance coverage that is comparable to the University Plan and your plan must be active for the entire semester that you are enrolled.