Student Health Services

Graduate Insurance Plan Summary of Coverage (84-page, 1.22 MB PDF file)
Graduate Insurance Enrollment Form (fillable PDF)
Graduate Plan Waiver Requirements  (PDF)
Graduate Plan Waiver (PDF)
What Is COBRA and How Is It Administered? (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 eligible graduate fellows are required to enroll in PacificSource insurance or file a waiver form with the student insurance office. Waiver details are listed under the link "Graduate Plan Waiver Requirements" above.

Can I enroll family members in this coverage?

Yes, the graduate fellow may enroll family members onto the PacificSource insurance. Family members must be added during the Open Enrollment period (October or the first month of the fellowship) 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. The graduate fellow 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 under "What does it cost?"

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 fellowship appointment begin and end dates. Insurance coverage will become effective on the first day of a month and will end on the last day of a month. If the fellowship begins before the 15th of the month, the insurance effective date will be the first of that month. If the fellowship begins the 16th or after, the insurance effective date will be the first day of the following month. It is important to make sure that all required paperwork, including signed letters of offer, graduate fellow appointment forms, and health insurance enrollment and/or waiver forms are processed in a timely manner.  Processing delays beyond the 16th of the month will result in double charges on the graduate fellow’s OSU business office account the following month.

What does it cost?

OSU will pay 85 percent ($238.29) of the yearly premium cost for graduate fellow-only coverage. Dependents can be added for an additional cost. Premiums for 2011-12 (charged on a per-month basis) are listed below:

Graduate fellow only coverage - $46.99 per month (15 percent)
Graduate fellow + Spouse/Partner - $347.72 (15 percent plus additional dependent cost)
Graduate fellow + Children (1 or more) - $257.49 (15 percent plus additional dependent cost)
Graduate fellow + Spouse/Partner + Children - $558.15 (15 percent plus additional dependent cost)

How do I pay for it?

The University will contribute 85 percent of the insurance premium plus one half of the administrative fee. Graduate fellows will be responsible for the remaining 15 percent plus one half of the administrative fee. If elected, additional coverage for dependents will be paid by the graduate fellow during the fellowship appointment period. Monthly charges will be applied to the graduate fellow’s OSU business office account. Graduate fellows are financially responsible for prompt payment of these expenses. Failure to clear charges on the OSU business office account may impact the fellow’s ability to register in subsequent academic terms.

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. Please return all forms to the SHS Insurance Office rather than to the PacificSource web site.

Fall Term: All eligible graduate fellows must fill out either a health insurance enrollment form or waiver form every Fall term if a break in the fellowship occurred during the summer term. Note: If you have a continuous fellowship through the summer, you must only complete a new form if you have changes in your address, phone number, or dependents. All late forms must be received in the Insurance office by the 10th of the starting month for payroll purposes as explained above.

Deadlines: Fall term – Oct. 1, 2011; Winter term – Jan. 1, 2012; Spring term – April 1, 2012 or Summer term – July 1, 2012

What if I have other insurance?

Graduate fellows who have other insurance may qualify to waive out of mandatory enrollment in PacificSource. However, graduate fellows 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, the graduate fellow’s alternate insurance plan must be similar in coverage to PacificSource. Waiver forms may be downloaded from the top of this page. A summary of coverage as well as a copy of both sides of the insurance card must accompany the completed waiver.

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 due to PacificSource benefit enhancements this year. 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 the same manner as described in the paragraph above. OSU will not pay for any portion of the cost of the alternate plan.

Note for international students: This is a change from last year.

Can I keep my coverage after my graduate fellowship ends?

COBRA Continuation Plan: ELIGIBILITY: If 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 graduate fellow, but the university would no longer be paying 85 percent of the premium. See link above 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 Fellow Plan. For information regarding this insurance, call the Customer Service phone number at 1-888-977-9299.

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. However, 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.

How is PacificSource billed for my services at SHS?

Once every two weeks, the SHS Billing Office runs a report, pulling all the charges for the students showing active on the insurance and sends the charges electronically to PacificSource for processing. These bills are then put through PacificSource’s Claims department to check for eligibility of student, whether it is a covered service, and whether or not the deductible has been met. PacificSource then sends an EOB (Explanation of Benefits) to the student explaining what was paid or wasn’t, and why. If the services were covered and deductible has been met, this EOB will be accompanied with a reimbursement check. This process generally takes 1-2 months from start to finish. Students are responsible for charges on their student account and we recommend the student pay them at the time they are billed, if they are 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. 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 to ask if they have received any billings for that date of service. PacificSource Customer Service can be reached 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