Student Injury and Sickness Insurance Plan for Sierra Nevada College 2013-2014
Sierra Nevada College is pleased to offer an Injury and Sickness Insurance Plan underwritten
by UnitedHealthcare Insurance Company. All undergraduate students are required to enroll in
the insurance plan, unless proof of comparable coverage is furnished.
Highlights of the Coverage and Services offered by UnitedHealthcare StudentResources are:
Up to $500,000 Per Insured Person, Per Policy Year Maximum Benefit for Covered Medical
$250 Deductible Per Insured Person Per Policy Year for Preferred Providers, $500 Deductible Per
Insured Person, Per Policy Year for Out of Network Providers.
Covered Medical Expenses for Preferred Providers are payable at 80% of Preferred Allowance and
Out of Network benefits are payable at 60% of Usual and Customary charges (all benefits are
subject to satisfaction of the Deductible, specific benefit limitations, maximums and Copays as
Preferred Provider Out-of-Pocket Maximum of $3,500 Per Insured Person, Per Policy Year. Out-of-Network
Out-of-Pocket maximum of $7,000 Per Insured Person, Per Policy Year. After the Out-of-Pocket Maximum has
been satisfied, Covered Medical Expenses will be paid at 100% up to the policy Maximum Benefit subject toany applicable benefit maximums. Refer to the plan certificate for details about how the Out-of-Pocket
Prescription Drug Benefits: $15 Copay for Tier 1 / $35 Copay for Tier 2 / $70 Copay for Tier 3
up to a 31-day supply per prescription filled at a UnitedHealthcare Pharmacy (UHCP).
Prescriptions must be filled at a UHCP network pharmacy. Mail order through UHCP at 2.5 times
the retail copay up to a 90 day supply.
Preventive Care Services which include, but are not limited to, annual physicals, GYN exams,
routine screenings and immunizations are covered at 100% with no Copay or deductible only whenthe services are received from a Preferred Provider. Please see www.healthcare.gov for complete
details of the services provided for specific age and risk groups.
Coverage available for eligible Dependents.
The Preferred Provider Network for this plan is UnitedHealthcare Choice Plus. Preferred Providerscan be found using the following link, http://www.uhcsr.com/lookupredirect.aspx?delsys=52
FrontierMEDEX – Domestic Students are eligible for FrontierMEDEX services when 100 miles ormore away from your campus address and 100 miles or more away from your permanent homeaddress. International Students are covered worldwide except in their home country.
Online Services: UnitedHealthcare StudentResources Insureds have online access to their claimsstatus, EOBs, ID Cards, network providers, correspondence and coverage account information bylogging in to My Account at www.uhcsr.com/myaccount. To create an online account, select the“create My Account Now” link and follow the simple, onscreen directions. All you need is your 7-digit Insurance ID number or the email address on file. Insureds can also visit our mobile site atmy.uhcsr.com to access an electronic ID card. Your student health insurance coverage, offered by UnitedHealthcare Insurance Company may not meet the minimum standards required by the healthcare reform law for restrictions on annual dollar limits. The annual dollar limits ensure that consumers have sufficient access to medical benefits throughout the annual term of the policy. Restrictions for annual dollar limits for group and individual health insurance coverage are $1.25 million for policy years before September 23, 2012; and $2 million for policy years beginning on or after September 23, 2012 but before January 1, 2014. Restrictions on annual dollar limits for student health insurance coverage are $100,000 for policy years before September 23, 2012 and $500,000 for policy years beginning on or after September 23, 2012, but before January 1, 2014. Your student health insurance coverage puts a policy year limit of $500,000 that applies to the essential benefits provided in the Schedule of Benefits unless otherwise specified. If you have any questions or concerns about this notice, contact Customer Service at 1-800-767-0700. Be advised that you may be eligible for coverage under a group health plan of a parent's employer or under a parent’s individual health insurance policy if you are under the age of 26. Contact the plan administrator of the parent’s employer plan or the parent’s individual health insurance issuer for more information.
UnitedHealthcare StudentResources Each Child PRE-EXISTING CONDITION means a condition, regardless of the
29. Pre-Existing Conditions, except for individuals who have been
cause of the condition, for which medical advice, diagnosis, care or
continuously insured under the school's student insurance policy for
treatment was recommended or received during the 6 months immediately
at least 12 consecutive months; The period of the exclusion for a
preceding the Insured's Effective Date under the new coverage. The term
Pre-Existing Condition will be reduced by the aggregate period of
does not include genetic information in the absence of diagnosis of the
creditable coverage if the creditable coverage was continuous to a
condition related to such information or pregnancy.
date not more than 63 days before the Insured’s effective date of the
EXCLUSIONS AND LIMITATIONS
coverage under this policy. This exclusion will not be applied to an
No benefits will be paid for: a) loss or expense caused by, contributed
to, or resulting from; or b) treatment, services or supplies for, at, or
30. Prescription Drugs, services or supplies as follows:
a) Therapeutic devices or appliances, including: hypodermic needles,
syringes, support garments and other non-medical substances,
regardless of intended use, except as specifically provided in the
4. Nicotine addiction; except as specifically provided in the policy;
b) Immunization agents, except as specifically provided in the policy,
5. Milieu therapy, learning disabilities, behavioral problems, parent-child
biological sera, blood or blood products administered on an outpatient
problems, conceptual handicap, developmental delay or disorder or
c) Drugs labeled, “Caution - limited by federal law to investigational use”
8. Congenital conditions, except as specifically provided for Newborn
e) Drugs used to treat or cure baldness; anabolic steroids used for body
9. Cosmetic procedures, except cosmetic surgery required to correct
f) Anorectics - drugs used for the purpose of weight control;
an Injury for which benefits are otherwise payable under this policy or
g) Fertility agents or sexual enhancement drugs, such as Parlodel,
Pergonal, Clomid, Profasi, Metrodin, Serophene, or Viagra;
10. Custodial Care; care provided in: rest homes, health resorts, homes
for the aged, halfway houses, college infirmaries or places mainly for
i) Refills in excess of the number specified or dispensed after one (1)
domiciliary or Custodial Care; extended care in treatment or
substance abuse facilities for domiciliary or Custodial Care;
31. Reproductive/Infertility services including but not limited to: family
11. Dental treatment, except for accidental Injury to Sound, Natural
planning; fertility tests; infertility (male or female), including any
services or supplies rendered for the purpose or with the intent of
12. Elective Surgery or Elective Treatment;
inducing conception; premarital examinations; impotence, organic or
otherwise; female sterilization procedures, except as specifically
14. Eye examinations, eye refractions, eyeglasses, contact lenses,
provided in the policy; vasectomy; sexual reassignment surgery;
prescriptions or fitting of eyeglasses or contact lenses, vision
correction surgery, or other treatment for visual defects and
32. Research or examinations relating to research studies, or any
problems; except when due to a covered Injury or disease process;
treatment for which the patient or the patient’s representative must
15. Flat foot conditions; supportive devices for the foot; fallen arches;
sign an informed consent document identifying the treatment in
weak feet; chronic foot strain; symptomatic complaints of the feet;
which the patient is to participate as a research study or clinical
and routine foot care including the care, cutting and removal of
corns, calluses, toenails, and bunions (except capsular or bone
33. Routine Newborn Infant Care, well-baby nursery and related
Physician charges, except as specifically provided in the policy;
16. Health spa or similar facilities; strengthening programs;
34. Services provided normally without charge by the Health Service of
17. Hearing examinations; hearing aids; or other treatment for hearing
the Policyholder; or services covered or provided by the student
defects and problems, except as a result of an infection or trauma.
"Hearing defects" means any physical defect of the ear which does
35. Skeletal irregularities of one or both jaws, including orthognathia and
or can impair normal hearing, apart from the disease process;
mandibular retrognathia; temporomandibular joint dysfunction;
deviated nasal septum, including submucous resection and/or other
surgical correction thereof; nasal and sinus surgery, except for
20. Immunizations, except as specifically provided in the policy;
preventive medicines or vaccines, except where required for
36. Skydiving, parachuting, hang gliding, glider flying, parasailing, sail
treatment of a covered Injury, or as specifically provided in the policy;
planing, bungee jumping, or flight in any kind of aircraft, except while
21. Injury or Sickness for which benefits are paid or payable under any
riding as a passenger on a regularly scheduled flight of a commercial
Workers' Compensation or Occupational Disease Law or Act, or
22. Injury or Sickness outside the United States and its possessions,
38. Speech therapy; naturopathic services;
Canada or Mexico, except for a Medical Emergency when traveling
39. Suicide or attempted suicide while sane or insane (including drug
for academic study abroad programs business or pleasure;
overdose); or intentionally self-inflicted Injury;
23. Injury sustained by reason of a motor vehicle accident to the extent
40. Supplies, except as specifically provided in the policy;
that benefits are paid or payable by any other valid and collectible
41. Surgical breast reduction, breast augmentation, breast implants or
breast prosthetic devices, or gynecomastia; except as specifically
24. Injury sustained while (a) participating in any intercollegiate or
professional sport, contest or competition; (b) traveling to or from
42. Travel in or upon, sitting in or upon, alighting to or from, or working
such sport, contest or competition as a participant; or (c) while
on or around any motorcycle or recreational vehicle including but not
participating in any practice or conditioning program for such sport,
limiting to: two- or three-wheeled motor vehicle; four-wheeled all-
terrain vehicle (ATV); jet ski; ski cycle; or snowmobile;
43. Skiing, snowboarding, scuba diving, surfing, roller skating,
27. Outpatient Physiotherapy; except for a condition that required
44. Treatment in a Government hospital, unless there is a legal obligation
surgery or Hospital Confinement: 1) within the 30 days immediately
for the Insured Person to pay for such treatment;
preceding such Physiotherapy; or 2) within the 30 days immediately
45. War or any act of war, declared or undeclared; or while in the armed
following the attending Physician's release for rehabilitation;
forces of any country (a pro-rata premium will be refunded upon
28. Participation in a riot or civil disorder; commission of or attempt to
request for such period not covered); and
46. Weight management, weight reduction, nutrition programs, treatment
for obesity, surgery for removal of excess skin or fat.
Bulletin of the CONNECTICUT ACADEMY OF SCIENCE AND ENGINEERING The following is excerpted from press releases of the National Academies and from Infocus Magazine, a news resource of the National Academies, which can be found at electrochemical reactions, form the heart of fuel cell power generation systems. They Climate Change Plan Falls Short desirable emissions and
IMPLEMENTING PROBLEM-BASED LEARNING IN Nanyang Technological University, Singapore Paya Lebar Methodist Girls' Secondary School, Singapore This paper reports on how problem-based learning was incorporated into the biology curriculum in a secondary three class. The focus of the paper is on how the students generated ideas for their problems, the types of questions that they asked, and
Student Injury and Sickness Insurance