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As you may be aware, beginning in 2014 the Affordable Care Act requires most U.S. citizens and legal residents to have health insurance or pay a tax penalty. Sometimes this is called the "individual mandate." This health insurance must be "minimum essential coverage," which is a type of health insurance coverage approved by the federal government, such as job-based coverage, government health programs (e.g., Medicare, Medicaid), and certain other coverage. We're happy to report that your university's 2013-2014 self-funded student plan qualifies as minimum essential coverage. So even though you can shop for other coverage in the new health insurance marketplace (also known as the health insurance exchange), you don't need to because your student health coverage meets the individual mandate. If you have any questions about this information, please let us know. You can learn more about the marketplace by visiting HealthCare.gov.
If you have more questions on waivers, please contact the Student Health Center at (208) 496-9330.
|Coverage Option||Regular On-Campus & Away-From-Campus Coverage||Extended Coverage|
|Student (Single & Married)||Semester||$398||$897 per month|
|Students & Dependants(s)||Semester||$1,498||$1,368 per month|
The BYU-Idaho Student Health Plan(SHP) is a student health plan offered by BYU-Idaho that continues to offer comprehensive health benefits to BYU-Idaho students and, if enrolled in coverage with an additional contribution, their dependents. The SHP will pay for medical services incurred both at the on-campus Student Health Center and from off-campus medical providers.
Honestly, the change from the SHP being an insured plan to a self-funded plan doesn't affect you or your benefits much at all. What is covered and not covered under the SHP has not changed for the 2013-2014 year in any significant way at all. If you have any specific benefit questions, call Deseret Mutual at 801-578-5600.
As is done every year, contributions are calculated each year for your SHP coverage based off of the benefits offered, as well as past SHP experience (i.e. the number and amount claims that the SHP has paid in recent years). One thing that is important to remember is that neither BYU-Idaho nor Deseret Mutual make a profit from the SHP or its contributions.
By introducing a $500 deductible for all students covered by the SHP ($1,000 deductible per family), the SHP is able to:
*Please remember that the $500.00 deductible only applies to non-preventive services received outside of the on-campus SHC.*
BYU-Idaho, like many prominent universities, including: the University of California system (UCLA, UC Berkeley, UC Santa Cruz, etc.); Harvard University, Massachusetts Institute of Technology, Princeton University, University of Iowa, University of Wisconsin, Yale University, as well as BYU and BYU-Hawaii is following a national trend to make the Student Health Plan (SHP) self-funded.
Becoming a self-funded plan allows BYU-Idaho to not only sponsor the SHP, but it also allows BYU-Idaho to be in direct control of the benefits offered by the SHP, including the way benefits and customer service are delivered to its participants. That direct control makes becoming a self-funded plan very attractive for school sponsored college health plans (see above list of notable schools that feel the same).
The ability for the SHP to become a self-funded plan was made possible through Idaho State legislation that was passed in the recent Spring 2013 legislative session. The Student Health Plan is currently completing the process to be self-funded to be in effect at the start of the 2013-2014 academic year.
As mentioned before, this change will put BYU-Idaho in direct control of SHP benefits. This means that BYU-Idaho will have more flexibility with plan benefits and be able to respond uniquely to its students’ specific health needs in a way that a fully-insured plan isn’t able to.
An additional change to the SHP this year is the introduction of a $500 deductible for all students and their covered dependents (with a $1,000 maximum deductible per family). In the past several years, it has only been married students who have had an upfront deductible under the SHP ($750 individual; $1,500 family). Now, all students, married or single, will have an up-front deductible that is consistent. Another change is that there will be only two contributions charged: one for student-only coverage and another for student and dependent coverage. This is another example of introducing consistency, so that a student won’t see his/her individual SHP deductible rise just because he/she gets married during the school year.
No, they do not. All students will be treated the same way that they have always been treated.
At this time we have had limited response from the students. We are trying to be proactive by delivering information as it becomes available using the SHC home web page.
All students covered by the SHP will pay the $500 up-front deductible when they receive services outside of the Student Health Center. One important exception is that currently established preventive services will be exempt from the up-front deductible, no matter where a student or their covered dependent receives those services (i.e. at the Student Health Center or through an off-campus provider).
a. Deseret Mutual in Salt Lake City, UT will continue to process SHP claims and provide customer service support for the SHP. Deseret Mutual has performed these services for the BYU-Idaho SHP since the SHP’s inception. Deseret Mutual has done (and continues to do) the same for the BYU and BYU-Hawaii SHPs.
The SHP will continue to provide services for the students and eligible dependents as it has done so in the past. There will be no notable changes
The Student Health Center is your primary source of medical care. If you need to receive treatment, make your first appointment with the SHC. If the SHC can't treat you, you'll be referred to a contracted physician in the community. You must preauthorize all care you receive outside the SHC. The SHC will coordinate the preauthorization process. If you need to see a physician outside of the SHC make sure your provider is contracted with the Deseret Mutual's Preferred Provider Network. If you use non-contracted providers, your benefits will be lower. For help finding a contracted provider, contact Deseret Mutual. If you use non-contracted providers, you will be responsible to pay any charges over maximum allowable amounts.
If you need health care after hours, go to the nearest contracted urgent care facility or the nearest hospital emergency room, or dial 911.
The Student Health Plan now includes prescription drug coverage for everyone. (Something about lower cost to administer the service this way) As such, health plan contributions have changed. Please refer to the table above or to the Student Health Plan Handbook for more details.
Beginning this 2012-2013 academic year, the Affordable Care Act (otherwise known as "health-care reform") mandates a number of preventive services to be covered by the Student Health Plan, with no cost to you when you see a contracted (or "network") provider. For a list of the covered preventive services, see the Student Health Plan Handbook.