Smcc

All students enrolled in 9 or more credits per semester are required to have health insurance as a condition of enrollment. This policy is designed to better protect students and their families from the rapidly escalating costs associated with illness or injury. Prior to instituting this policy, many SMCC students incurred bills at local emergency rooms for non-emergent care because SMCC does not have a student health center and they did not have access to their primary care physician locally. In addition, NEASC accreditation requires colleges with full-time or residential students to provide "access to health care." Requiring insurance for these populations is how SMCC meets this accreditation standard. 

Students will be automatically enrolled in and billed for SMCC’s Student Accident and Sickness Insurance Plan; however, families and/or students will be able to waive the SMCC coverage if students are covered under an existing U.S. based health insurance plan of comparable coverage and complete the online waiver by the published deadline. 

Students can be insured by more than one plan. Families may choose to maintain their private insurance as well as the SMCC Plan for access to care and coverage. In such cases, the SMCC Plan will be secondary to any other insurance plan.  This is a particularly good idea if your private plan has a high deductible.

What is the Cost of SMCC's Health Insurance Plan and What is Covered?

For those who purchase the SMCC Plan for the 2010-2011 academic year (coverage from August 15, 2010, to August 15, 2011), the annual cost will be $368. Students who pay in the Fall do not need to pay again in the Spring; however, because insurance coverage changes, they will need to waive annually each Fall.

For students who enroll in nine hours or more beginning in January (new students or students who were previously enrolled in fewer than 9 credits), coverage will be effective from January 1, 2011 until August 15, 2011, and cost $246. These students will need to waive again the following Fall, then annually in the Fall thereafter.  Students who are enrolled in fewer than 9 credits are not eligible to enroll in and do not need to waive the Student Insurance Plan.

Please note that the SMCC Plan is an accident and sickness plan, and will not cover routine exams or preventative care services except as mandated by state and federal laws.  There are a few exceptions to this.  For more information, please refer to the SMCC Student Health Insurance Waiver and Enrollment Brochure (for a broad overview) or the SMCC Master Policy (for more detailed information).

• Enrollment in this Plan will provide coverage for 100% of eligible charges up to a maximum benefit of $2,000 for medical expenses incurred as a result of a covered accident or sickness. Payments will be made as allocated for certain covered medical expenses incurred for an injury or sickness while covered on this plan.
  Supplemental Expense Benefit: after the basic benefit maximum of $2,000 per sickness or covered accident, remaining eligible expenses are payable at 80% up to a policy aggregate maximum benefit of $10,000 for any one sickness or covered accident. Hospitalization, including room and board, general nursing care, diagnostic testing, surgery and medicines. Outpatient diagnostic testing and lab work, outpatient hospital services, including emergency care and surgery.Mental Health and Substance Abuse services are covered as any other accident or sickness.   Prescription Drug Coverage up to $500.00.

In addition, students may insure a spouse or child or "buy up" to $50,000 worth of coverage for the student (but not for an eligible dependent) for an additional fee. These options are available when waiving or enrolling at www.crossagency.com/smcc.

How Do I Know if I am Eligible to Waive SMCC's Health Insurance Plan?

In order to be eligible to waive SMCC's policy, you must be covered by a U.S. based health insurance plan that provides:

1. Access to local doctors and other health-care providers
2. Diagnostic testing/lab services
3. Prescription drugs
4. Outpatient mental health
5. Inpatient and outpatient hospital services
6. Emergency services

In addition, the policy must be in effect from August 15, 2010 to August 15, 2011.

What is the Process for Waiving SMCC's Health Insurance Plan?

1. Go to www.crossagency.com/smcc.
2. Click on “Waive Out of the SMCC Insurance Plan,” the second link from the top and follow the instructions. 
3. You will need to have details regarding your current coverage available in order to fully complete the online waiver.
4. SAVE THE CONFIRMATION PAGE FOR YOUR RECORDS!

Q & A

What if I need to see a doctor right away?

If you need to see a doctor right away but have not yet received your card from Aetna, you can go to www.crossagency.com/smcc and enroll in the policy. Simply click on the “Enroll in the SMCC Insurance Plan” link, the third link from the top. This will allow you to positively enroll in the policy so that you can then register as a member on the Aetna web site and gain access to a copy of your ID card, the provider finder directory and in the future, your claims.

I am having trouble completing the waiver/enrolling in the policy. What do I do?

If you cannot login to the waiver, it is likely because SMCC has not confirmed that you are an eligible student (i.e. enrolled in 9 credit hours or more). Please wait one week after you register in your ninth credit hour for your login to become active. Three weeks prior to the waiver deadline, SMCC will upload active student lists to Aetna's website on a daily basis, Monday through Friday. During this period, please wait 24 business hours before trying to enroll/waive.

I don't have 9 credit hours. Can I enroll in the policy?

Unfortunately no. SMCC's policy is a group policy that requires students to be full-time students, which SMCC defines for insurance purposes as 9 credit hours or more.  However, if you go to www.aetnastudenthealth.com, Aetna may have other insurance policy offerings that you can purchase from them directly.

I am trying to see a doctor and/or resolve a claim with SMCC's former insurance carrier, Gallagher-Koster. What should I do?

All SMCC students covered under prior year (before Fall 2009) policies who are trying to resolve claims may still do so by contacting Gallagher-Koster directly. Gallagher-Koster has a robust web site that will likely include much of the information you are seeking: www.gallagherkoster.com. SMCC students may also call Gallagher-Koster at 1-800-406-4517. In addition, students may contact the Claims Company, Pioneer Management Systems, Inc. by email at student@pioneerhealth.com or by phone at 877-868-9060.  Pioneer's web site is www.pioneeerhealth.com.

I have a question that I cannot find the answer to in the printed materials (above) or at www.aetnastudenthealth.com.  Who can I ask?

Please contact Cross Insurance. The Cross Agency is the insurance agency that manages SMCC's policy with Aetna. You can contact either of SMCC's representatives, Lisa Farrington or Michael Parkin, during business hours by calling 1-800-537-6444.