Graduate Assistant Insurance Plan (2016-17)

Is it mandatory?

Yes, all students who have graduate assistantships of .2 to .49 FTE are automatically enrolled for "employee-only" coverage in PacificSource insurance. Those who would like to opt out must submit a waiver form with comparable insurance coverage to the SHS Insurance Office by the deadline listed under “What paperwork do I need?”

Waiver details are listed under the link "Graduate Plan Waiver Requirements" at the top of this page.

What does it cost?

Premiums for 2016-17 (per-month, pre-tax payroll deduction) are listed below:

Employee-only coverage - $49.25 per month (13%)
Employee + Spouse/Partner - $96.84 per month (13% plus 13% of additional dependent cost)
Employee + Children (1 or more) - $82.56 per month (13% plus 13% of additional dependent cost)
Employee + Spouse/Partner + Children - $130.14 per month (13% plus 13% of additional dependent cost)
Dental only: $36.84 per month

Per the collective bargaining agreement (Article 28), OSU will cover 87% (or $295.44/month) of the premium cost for employee-only coverage while employed, and graduate assistants will pay the remaining 13%. Dependents can be added for an additional cost. 

How do I pay for it?

The monthly premium amount will be deducted from your paycheck. 

What paperwork do I need?

You need to complete either 1) an enrollment form if you are making changes or adding dependents, or 2) a waiver and then submit it to the Student Health Insurance Office no later than the deadline listed below for the given term. Please do not submit forms earlier than six months prior to the insurance start date or without a local address. Enrollment forms are available for download at the top of this page, or in the Student Health Insurance Office. Some departments may include an enrollment form in their hiring packet. Please return all forms to the SHS Insurance Office rather than to the PacificSource website.

NOTE about fall enrollment forms/waivers: If you were on the Graduate Summer Insurance at 87%, we will continue that same policy. All forms must be submitted by the deadline listed below, depending upon the term in which your assistantship begins.

Deadlines for form submission: All enrollment forms adding dependents or making corrections, along with waiver forms, must be submitted within the first 30 days of employment. The deadline for fall term is October 16th.

What benefits are included?

PacificSource Insurance benefits include a comprehensive medical, dental, and vision plan. Medical, vision, and dental benefits are listed in their respective PDFs above.

When will my insurance be effective?

The health insurance plan year runs from October 1 to September 30. However, insurance coverage is on a month-to-month basis and will be based on the graduate assistant appointment begin and end dates. Your insurance will become effective on the 1st of a month and end on the last day of a month. If your assistantship began before the 15th of the month, then your insurance effective date will be the first of that month. If your assistantship began the 16th or after, then your insurance effective date will be the 1st of the following month. It is important to make sure that all departmental paperwork is completed and received by OSU Human Resources and Payroll for processing. If processing is delayed and your information is not entered into the system before the 16th, you will see a double deduction on your paycheck the following month.

Can I enroll family members in this coverage?

Yes, the student may enroll family members who qualify as eligible dependents. Family members must be added during the Open Enrollment period (October or the first month of the assistantship) by including the name, date of birth and Social Security number in Section 3 of the PacificSource enrollment form. To enroll family members outside of the Open Enrollment period, a Qualifying Event needs to occur, such as a marriage, birth, adoption, court order or involuntary loss of other coverage (provide Certificate of Loss of Coverage). The student must submit an enrollment form to the SHS Insurance Office by the first day of the month to be added. The additional costs for family members are listed below.

How do I use my coverage outside of Student Health?

For services outside of the Student Health Center, please refer to the list of Preferred Providers which may be found online at www.PacificSource.com (choose the plan type – PSN). When you go to that provider for an appointment, you will need to present your insurance card so that the office can bill PacificSource for your visit. Some offices will ask you to pay your percentage up front, or may bill you after they have received an Explanation of Benefits from PacificSource. If you receive a billing from an outside provider that you do not understand, or does not look as if it has been charged to PacificSource, you should call the billing office for that doctor for clarification. You can also call PacificSource Customer Service at 1-888-977-9299 to ask if they have received any billings for that date of service.

How is PacificSource billed for my services at SHS?

Every week, the SHS Billing Office sends the SHS charges electronically to PacificSource through our clearinghouse, Navicure, for processing. After processing, PacificSource then sends an Explanation of Benefits (EOB) to Student Health Services and the student explaining what was paid or wasn’t, and why. If the services were covered and the $100 deductible has been met, this EOB will be accompanied with a reimbursement check to Student Health Services. This process generally takes one to two months from start to finish. Students are responsible for paying charges on their student account and we recommend the student pay them at the time they are billed, if financially able. For any further questions on this process, you may contact the SHS Billing Office at 541-737-8370.

What if I have other insurance?

Students who have other insurance may qualify to waive out of enrollment in PacificSource. However, graduate assistants who waive out of the university plan will not be eligible for the university’s contribution toward premiums. In order to qualify for a waiver, your insurance plan must cover the services listed on the “Waiver Requirements” to be considered comparable to the PacificSource plan. The Aetna OSU Student Insurance Plan is not a comparable plan. A summary of coverage as well as a copy of both sides of the insurance card must accompany the completed waiver for review by the deadline.

The university offers a dental benefit through PacificSource for those students who are missing dental coverage, but have all the medical and vision services required. The cost of the added dental premium will be $36.84 monthly. The student will be required to complete an enrollment form and authorize the premium to be deducted from their paycheck monthly.

My appointment has changed. Do I have to submit new forms?

Graduate students whose appointments convert from an assistantship to a fellowship from one term to the next (that is, the appointments are sequential with no lapse between appointment periods), will not be required to submit a new health insurance enrollment or waiver form. NOTE: If there is any lapse in time between appointments, the automatic enrollment will for employee-only coverage at the start of the new position. Any corrections, or waivers, must be submitted within the first 30 days of employment. Please contact the SHS Insurance Office with any questions by calling 541-737-7568.

Can I keep my coverage after my assistantship ends?

Yes, there are two options for continuing the PacificSource insurance depending upon your situation – the Graduate Assistant Summer Insurance at 87% and the COBRA Continuation Plan.

Graduate Assistant Summer Insurance at 87%: Effective summer 2017 and contingent upon the contract being ratified (see below).

ELIGIBILITY: You are eligible for this plan if you have had a graduate assistantship during fall, winter and/or spring term, but not during summer term and will continue as a graduate assistant in the coming fall. The university and PacificSource offer the ability to keep your same coverage with the university paying 87% of the monthly premium and the student paying the other 13%. Students will automatically be enrolled for the summer coverage. One-ninth of the summer premium will be deducted monthly from each paycheck. If you would like to opt out of the summer coverage, you may do so by May 1, 2017. The opt-out form is listed at the top of the page.

COBRA Continuation Plan:

ELIGIBILITY: If your assistantship ends or you are leaving the university, you have the option of enrolling in the COBRA Continuation Plan for 18 months. COBRA coverage is a continuation of the same PacificSource coverage you had as a GTA or GRA, but the university would no longer be paying 87% of the premium. See link at the top of this page for enrollment details and deadlines entitled “COBRA Options.” Additional information about COBRA coverage can be obtained by calling PacificSource Administrators COBRA at 1-877-355-2760.

PacificSource may also send information to you regarding Portability Insurance. This is insurance from PacificSource, but the coverage is not the same as the coverage within the Graduate Assistant Plan. For information regarding this insurance, call the Customer Service phone number at 1-888-977-9299.

Who can I contact if I have more questions?