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" links above.
Is it mandatory?
Yes, all eligible graduate fellows are required to enroll in PacificSource insurance or file a waiver form with comparable insurance coverage to the SHS Insurance Office by the deadline listed below. Waiver details are listed under the link "Graduate Plan Waiver Requirements" above.
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 – PLEASE WRITE ‘REVISED’ IN UPPER RIGHT HAND CORNER. All late forms must be received in the Insurance office by the 10th of the starting month for payroll purposes as explained above.
Deadlines for form submission: Fall term – Oct. 1, 2015; Winter term – Jan. 1, 2016; Spring term – April 1, 2016 or Summer term – July 1, 2016 (Does not apply to optional summer insurance plan. Dates will be emailed out for deadline submission.)
When will my insurance be effective?
The health insurance plan year runs from Oct. 1 to Sept. 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 on 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.
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 (provide Certificate of Loss of 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.
What does it cost?
OSU will pay 85 percent ($282.69) of the monthly premium cost for graduate fellow-only coverage. Dependents can be added for an additional cost; graduate fellows will pay 15 percent of the premium and the remaining 85 percent cost will be covered by OSU.
Premiums for 2015-16 (charged on a per-month basis) are listed below:
Employee-only coverage - $54.83 per month (15 percent)
Employee + Spouse/Partner - $108.56 per month (15 percent plus 15 percent of additional dependent cost)
Employee + Children (1 or more) - $92.43 per month (15 percent plus 15 percent of additional dependent cost)
Employee + Spouse/Partner + Children - $146.16 per month (15 percent plus 15 percent of additional dependent cost)
Dental only: $36.84 per month
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 and OSU (15 percent each) 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.
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 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. This process generally takes 1-2 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.
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 at1-888-977-9299 to ask if they have received any billings for that date of service.
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 considered comparable to the PacificSource plan. 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 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 $36.84 monthly. The student will be required to complete a form to elect the dental coverage. The dental premium will be applied to the graduate fellow’s OSU business office account 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 vision benefits, higher deductible, and higher out-of-pocket maximum 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 fellowship to an assistantship 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 graduate fellowship ends?
Yes, there are two options for continuing the PacificSource insurance depending upon your situation – the Graduate Fellow Summer Insurance at 85 percent 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 Fellow Summer Insurance at 85 percent: Effective Summer 2016 and contingent upon the contract being ratified (see below).
ELIGIBILITY: You are eligible for this plan if you have had a graduate fellowship during fall, winter and/or spring term, but not during summer term and will continue as a graduate assistant or fellow 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. Deadlines for submission of the summer insurance forms will be emailed out to the student and student’s department.
COBRA Continuation Plan: ELIGIBILITY: If your fellowship 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 graduate fellow, but the university would no longer be paying 85 percent of the premium. Please see the 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 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 Fellow 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?