Student Health Services

Graduate Insurance Plan Summary of Coverage (98-page, 1.59 MB PDF file)
Graduate Insurance Enrollment Form (PDF)
Graduate Plan Waiver Requirements and Waiver Form (PDF)
Graduate Assistant Summer Options (PDF)
Graduate Assistant COBRA Insurance Options (PDF)

What benefits are included?

PacificSource Insurance benefits include a comprehensive medical, dental, and vision plan. A complete PDF file of benefits is available for viewing by clicking on the "Summary of Coverage" link above.

Is it mandatory?

Yes, all students who have graduate assistantships of an FTE of .2 or above are required to enroll in PacificSource insurance or file a waiver form with the SHS Insurance Office by the deadline listed under “What paperwork do I need to do?”

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

What paperwork do I need to do?

You need to complete an enrollment form or waiver and submit 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 web site.

NOTE about Fall Enrollment forms/waivers: All graduate assistants must submit an enrollment form/waiver fall term UNLESS you have been on assistantship summer term and there are no changes in personal information (name, address, phone) or dependents. If you were on the Graduate Summer Insurance at 50%, or COBRA during the summer, a new form needs to be completed. All forms must be submitted by the deadline listed below, depending upon the term in which your assistantship begins.

Deadlines for form submission: Fall term – Oct. 1, 2012; Winter term – Jan. 1, 2013; Spring term – April 1, 2013 or Summer term – July 1, 2013

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 if the monthly salary is enough to cover the cost of the additional premium. 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.

What does it cost?

OSU will pay 85 percent ($248.40/month) of the premium cost for Employee-only coverage while employed. Dependents can be added for an additional cost. This year (contingent upon ratification of contract), students will cover 50 percent of the monthly premium cost for dependents and OSU departments will cover the other 50 percent.

Premiums for 2012-13 (per-month, pre-tax payroll deduction) are listed below:

Student only coverage - $48.77 per month (15 percent)
Employee + Spouse/Partner - $205.68 per month (15 percent plus 50 percent of additional dependent cost)
Employee + Children (1 or more) - $158.61 per month (15 percent plus 50 percent of additional dependent cost)
Employee + Spouse/Partner + Children - $315.48 per month (15 percent plus 50 percent of additional dependent cost)

Dental only: $26.45 per month

How do I pay for it?

The monthly premium amount will be deducted from your paycheck. The university will contribute 85 percent of the monthly insurance premium and students will be responsible for 15 percent. Additional coverage for dependents will be paid by the both the student (50 percent) and the student’s department (50 percent) during the period you have your assistantship. Paychecks must be large enough to accommodate the elected plan deduction.

How is PacificSource billed for my services at SHS?

Every two weeks, the SHS Billing Office sends the SHS charges electronically to PacificSource for processing. After processing, PacificSource then sends an Explanation of Benefits (EOB) to the student explaining what was paid or wasn’t, and why. If the services were covered and the $200 deductible has been met, this EOB will be accompanied with a reimbursement check. 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. Again, Student Health does not receive payment back for these services, so the patient IS responsible for these charges on their account. For any further questions on this process, you may contact the SHS Billing Office at 541-737-2068.

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 – Preferred 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.

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. 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.

This year, the university will offer 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 $26.45 monthly. The student will be required to complete a form and authorize the premium to be deducted from their paycheck monthly.

What if I would rather enroll in one of the other OSU Insurance plans?

The Domestic and International Aetna Student Insurance plans do not qualify as comparable plans to the PacificSource insurance due to no dental and vision benefits on the Aetna plans. Thus, neither can be used to waive out of the Graduate Assistant PacificSource Insurance plan. All international students will need to submit an International waiver, in addition to the PacificSource form, in order to be waived from the Aetna International plan. OSU will not pay for any portion of the cost of the alternate plan.

If my appointment changes from graduate assistant to graduate fellow or vice versa, do I have to submit a new health insurance enrollment or waiver form?

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, a new health insurance enrollment or waiver form will be required. Please contact the SHS Insurance Office with any changes 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 85% and the COBRA Continuation Plan. The enrollment details for both plans are listed under the link "Graduate Assistant Summer Insurance at 85% and COBRA Options" at the top of this page.

Graduate Assistant Summer Insurance at 85%: New for 2012-13; effective Summer 2013 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 student in the coming fall. The university and PacificSource offer the ability to keep your same coverage with the University paying 85 percent of the monthly premium and the student paying the other 15 percent. Again, the premium contribution is only on the student, not on dependents. See link above for enrollment details and deadlines.

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 85 percent 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 will 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?

• OSU Student Health Insurance Office at 541-737-7568, or OSUstudent.insurance@oregonstate.edu
• SHS Billing Office at 541-737-2068
• PacificSource Customer Service at 1-888-977-9299, or cs@pacificsource.com