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Contact Information

Student Health Services
PO Box 1510
Pembroke, NC 28372

Phone: 910.521.6219
Fax: 910.521.6549
Email: shs@uncp.edu

Location: Student Health Services
Campus Map

 


STUDENT HEALTH INSURANCE

*Note: The Insurance waiver process for the Spring 2013 semester begins on November 1, 2012 and will end on January 31, 2013. See instructions below for completing a waiver. If you plan to keep the Student Health Insurance, do nothing and you will be billed.

 

BENEFIT CHANGES FOR 2012/2013
(IN RED)

Benefit Listing for Fall 2011 & Spring 2012 University-Sponsored Hard Waiver Plan$434/semester $868/year

In-Network Benefits

Benefit Listing for Fall 2012 & Spring 2013 University-Sponsored Hard Waiver Plan $709/semester $1418/year

In-Network Benefits

$100,000 per policy year.

$100,000 per policy year.

$0 Deductible per policy year.

$300 Deductible per policy year.

$2,000 Out of pocket Maximum per policy year (also referred to as Coinsurance Max) does apply to SHS visits.

$4,000 Out of pocket Maximum per policy year (also referred to as Coinsurance Max) does apply to SHS visits.

$150 co-pay for ER visits
(plus applicable deductible & coinsurance.)

$ 300co-pay for ER visits, $75co-pay for urgent care (plus applicable deductible & coinsurance) ER co-pay waived if admitted.

$0 Office visit co-pay.

$20 Office visit co-pay

$0 co-pay for x-rays, laboratory tests and procedures does not apply to SHS visits.

$10 co-pay for x-rays, laboratory tests and procedures does not apply to SHS visits.

$0 co-pay per 30-day supply for generic/brand prescriptions at SHS.

$25/$50/$100 based on a 3 tier formulary and then covers 80% after co-pay $100,000 max.

$500 injection /immunization benefit per policy year.

Some immunizations are covered under the preventive care plan.

$500 Wellness (Preventive Care) benefit per policy year (includes wellness services both in & outside SHS; wellness services provided outside SHS are subject to co-pay, deductible, and coinsurance.)

$500 Wellness benefit per policy year (includes wellness services both in & outside SHS; wellness services provided outside SHS are subject to co-pay, deductible, and coinsurance ) Preventive Care Maximum is $100,000.

$3,000 Intercollegiate sports benefit per policy year.

$3,000 Intercollegiate sports benefit per policy year

No Vision Coverage.

Vision Coverage $200 maximum

Elective Abortion Benefit, students can decline this specific benefit, but it has no bearing on premium cost.

Elective Abortion Benefit, students can opt in this specific benefit, but it has no bearing on premium cost. The benefit is not automatically included in coverage.  To elect this benefit a covered student must opt-in.

 

 

The University of North Carolina
System-Wide Student Health Insurance Plan
Overview for the University of North Carolina at Pembroke

In August 2009, the UNC Board of Governors approved the implementation of a “hard waiver” student health insurance plan on all sixteen 4-year campuses beginning in fall 2010.  The term “hard waiver” means any student meeting three specific criteria is required to show evidence of an existing “creditable coverage” health insurance policy *1 OR enroll in the UNC system-wide plan *2. 

“Hard waiver” does not mean a student must enroll in the UNC system-wide plan; it means a student must show evidence of creditable coverage health insurance, and enrolling in the UNC system-wide plan is one means to meet that requirement.  A student is encouraged to compare the UNC system-wide plan against other options, e.g., being a dependent on a parent’s health insurance plan, having an employer’s health insurance plan, having individual plan coverage through another source.

The system-wide plan provides a common set of base benefits with several options for campus-selected plan enhancements.  The UNC system-wide plan has a robust set of benefits at an affordable premium.  The plan’s coverage can be expanded by a student to include a spouse/domestic partner *3 and/or child(ren).  The plan’s coverage is from August 1st – July 31st and is billed by semesters (defined as August 1st – December 31st and January 1st – July 31st).

Why was a “hard waiver” plan created?
UNC campuses have had in the past a wide variety of student health insurance plans.  Thus, students had access to significantly different coverage and pricing based on the campus attended.  Plans varied widely in premium cost, maximum basic benefits, deductibles, coinsurance, plan design, major medical options, co-pays for prescription drugs, and eligibility for participation.  In addition, five of the sixteen campuses had voluntary plans that created a population of uninsured students on campus.  The UNC Board of Governors held policy discussions on May 7th and August 13th, 2009.  The outcome was a unanimous decision by the BOG to implement a system-wide student health insurance requirement, i.e., the hard waiver model.  The materials discussed at the BOG meetings can be found at:

  • http://www.northcarolina.edu
  • click on “Leadership”
  • click on “Board of Governors”
  • click on “Pre-meeting Materials”
  • then find May 8th and August 14th, 2009; there are several pdf files you can print.

 
What are the criteria that require a student to have health insurance?
The three criteria that invoke the requirement to have health insurance and also define a student as eligible to enroll in the system-wide student health insurance plan are:

  • enrolled in a degree-seeking program, *4 AND
  • enrollment in a minimum of 6 credit hours, *5 AND
  • eligible to pay the campus student health fee.

How does a student waive out of the UNC system-wide student health insurance plan?
Any student meeting all three criteria above who has an existing creditable coverage health insurance policy is able to waive out of the UNC system-wide plan easily and quickly on-line.  No paperwork is required.  The web portal to waive out of the UNC system-wide plan for Fall 2012 and Spring 2013 opens for UNCP on May 10, 2012 at www.studentinsurance.com/Schools/NC/UNCP with policy verification beginning on June 1, 2012.  Waivers requests submitted April 1-May 31 will be put into the queue for June 1st verification review.  Response to a waiver request submission is typically made in no more than 3 business days.
 
What happens if a student does not waive out of the UNC system-wide student health insurance plan?
A student who meets the three criteria above is automatically enrolled in the UNC system-wide plan each semester and is obligated for the cost of the plan for that semester -- unless the student submits a waiver request at www.studentinsurance.com/Schools/NC/UNCP that is successfully verified as creditable coverage.  The UNC system-wide plan’s premium is included in the "cost of attendance" used for financial aid consideration. 

What does the UNC system-wide student health insurance plan cover at UNCP?
The plan’s benefits include 100% coverage of services at the UNCP Student Health Center, a $300 deductible, 80% coinsurance of PPO allowance, $100,000 medical per sickness or injury per policy year, $100,000 pharmacy maximum (with a $10 co-pay at the UNCP Student Health Center and $25/$50/$100 at an outside pharmacy) a $500 wellness benefit.

What is the premium at UNCP for the UNC system-wide student health insurance plan?
UNCP’s annual premium for the system-wide plan plus UNCP’s campus-selected enhancements is $1,418 ($709 each semester).  It is paid each semester through the student’s campus account.  A student can add annual dependent coverage for $3,634/year ($1,817 each semester) for spouse/domestic partner; $2,236 for a child(ren) ($1,118 each semester).  Premiums for dependents are paid directly to Pearce & Pearce and do not go through the student’s campus account.  The benefits for dependents are equal to the UNC system-wide plan’s base coverage; whereas a student’s benefits are equal to the base benefits plus the campus-selected enhancements. 

What if a student is not eligible for the UNC system-wide student health insurance plan?
A student who is not eligible to purchase the UNC system-wide plan under the three criteria described earlier has access to a “voluntary” rated student health insurance plan if the student is: a) eligible to pay the campus student health fee, AND b) is either enrolled in a degree-seeking program4 OR enrolled in a minimum of 6 credit hours.  The annual premium is $2,449.  A student can add dependent coverage for spouse/domestic partner for an annual premium of $4,898. The annual premium for a child(ren) is $3,675. The benefits for dependents are equal to the UNC system-wide plan’s base coverage.  Premiums are paid directly to Pearce & Pearce and do not go through the student’s campus account.

What happens when a student leaves UNCP?
A voluntary rated health insurance plan is available to any currently covered student for up to six (6) months from the time the student’s plan ends (either December 31st or July 31st) AND the student either graduates from or discontinues enrollment from UNCP.  “Covered” student includes both students on the UNC system-wide plan or other plans accepted for a waiver.  The student premium for the six months is $2,449.  Benefits are equal to the UNC system-wide plan’s base coverage. Premiums are paid directly to Pearce & Pearce and do not go through the student’s campus account.

What is the UNC system-wide voluntary student dental plan?
In addition to the UNC system-wide student health insurance plan, there is a UNC system-wide voluntary dental plan available to all students.  This plan is separate from the UNC system-wide student health insurance plan and it is a student’s choice to enroll or not to enroll.  The premium is on an annual basis (not by semester) and is $479.76 for a student; spouse/domestic partner coverage is $1,002.22; child(ren) coverage is $1,157.68; and family coverage is $1,680.14. Premiums are paid directly to Pearce & Pearce and do not go through the student’s campus account.

Where does a student get more information about the UNC system-wide student health insurance plan and the UNC system-wide voluntary student dental plan?
The Pearce & Pearce web site at www.studentinsurance.com/Schools/NC/UNCP will contain FAQs, definitions of terms, a benefits summary, claim forms and instructions, and other important information beginning June 1, 2012.

Footnotes
1 The term "creditable coverage" comes from the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and is defined as "coverage under another group health plan, an individual health insurance policy, COBRA, Medicaid, Medicare, CHAMPUS, the Indian Health Service, a state health benefits risk pool, FEHBP, the Peace Corps Act, or a public health plan."  

2 Graduate Research Assistants and Teaching Assistants as well as Fellows will continue to be covered under the Graduate Student Support Plan at UNC-CH and NCSU and do not fall under the UNC system-wide student health insurance plan described above.  Insurance premiums for Doctoral and Post Doctoral Fellows at ECU will continue to be supported by the individual campus departments at ECU.

3 Domestic partner eligibility requirements are defined by each UNC institution.

4 Degree-seeking is defined as “diploma-seeking” at UNCSA.

5  Graduate students at ECU, NCSU, UNCC, UNC-CH, and UNCW will be required to have health insurance if they are registered for 1 credit hour or more along with the other two criteria, i.e., enrolled in a degree-seeking program *4 AND eligible to pay the campus student health fee.

 

 

SETTING UP YOUR ACCOUNT

All students enrolled in the campus endorsed insurance plan must set up their account online
This is the first step to getting information and managing your Pearce & Pearce insurance needs on-line, including:

  • Online Claim Info
  • Printing Temporary ID Card
  • Benefits (Plan Summary)
  • How To Use Your Plan
  • Insurance Definitions
  • How To File A Claim
  • How To Read An EOB
  • Medcost Network Provider Search
  • Insurance Contact Information

Follow these steps to set up you Pearce & Pearce on-line account:

  • Go to studentinsurance.com (in the search box type UNCP)
  • Choose "My Account" at the top of the left-hand yellow column. A drop-down menu with appear. Choose "Create Account." This will bring you to a Student sign-on page. Students who have already set up their accounts can enter their e-mail address and chosen password. Students who still need to set up an account should click on the "Create Account" link at the bottom of the sign-on dialog box. This will take users to the "Create Account" page.
  • The next page asks students to input their student id, last name, date of birth, and e-mail address. Then they choose a password with 6-12 characters, including at least 1 upper case letter, 1 lower case letter and 1 number. Students enter the chosen password twice to confirm their choice, then click on the button "Create Account".
  • The next screen asks for the zip code on file with Pearce & Pearce as an additional security check. This will be the zip code where your insurance ID card was sent.
  • Once your request is processed (usually within 24 hours), you can login to your online account, print a temporary ID card, check on claims in process and change your profile as needed.

Note: To set up an account before the insurance company receives the list of insured students from UNCP - usually the first 30 days of school.

  • Go to www.studentinsurance.com (in search box type UNCP)
  • Choose Hard Waiver Enrollment on the left side of screen.
  • Click on the correct semester
  • Put a check beside item #3
  • Click on Mandatory Plan
  • Complete information and submit.
  • Once your request is processed (usually within 24 hours), you can login to your online account, print a temporary ID card, check on claims in process and change your profile as needed.

If you have any questions, please contact Student Health Services at 910-521-6219.

 

 

TEMPORARY ID CARDS

Permanent insurance cards will be mailed to the student’s home address in the next few weeks. However, students who have an on-line account with Pearce & Pearce, either by requesting a waiver or setting up an account in the mandatory plan on-line, can print out a temporary ID card by going to the student insurance web site:

  • Choose UNCP from the drop-down menu.
  • Choose My Account from the Yellow bar on the left-hand side of the screen.
  • Choose Print Temporary ID Card. This will take the enrollee to a secure area where the appropriate school year, student’s e-mail address and password previously set up in the Pearce & Pearce web site are required.
  • Once this information is submitted, the user will be taken to a screen where the student’s name, coverage period, effective date, termination date and current status will be shown.

Choose the VIEW button under ID, hit enter, and all pertinent policy information will be shown. The student can now print a temporary insurance card from this screen by choosing Print Temp ID Card. The temporary ID card shows coverage information in the first box and claims filing information in the second box. This card should be sufficient for use until the permanent card arrives.

If you have any questions, please contact Student Health Services at 910-521-6219.

 

 

WAIVER PROCEDURE

Spring Semester 2013: November 1, 2012 - January 31, 2013

Note the change in credit hours from nine (9) to six (6).

All registered students taking six (6) or more credit hours are required to purchase the student health insurance plan, with the following exceptions:  distance education students (students taking off campus and internet only courses) and students who submit evidence of equivalent coverage satisfactory to the policyholder may waive coverage.  If you do not submit a waiver form then you will automatically purchase the Student Health Insurance and the charge will remain on your student account.  If you have any questions, please contact Student Health Services.

For more information on Student Health Insurance, visit www.studentinsurance.com/Schools/NC/UNCP

How to complete your insurance waiver:

  •  Go to www.studentinsurance.com/School/NC/UNCP
  •  Find your institution
  •  Select waiver online
  •  Complete the waiver process
  •  You will be required to supply your health insurance information for verification.
  •  Make sure that you print and keep your confirmation number.
  •  Print email notice for approval or denial.
  •  Waivers submitted during the fall semester are also valid for the spring semester.
  •  If you need to cancel your waiver and enroll into the Student Health Insurance Plan, go to www.studentinsurance.com/Schools/NC/UNCP
  •  Waivers are only valid for the current academic year and will need to be updated each fall semester.
  •  If you want the school insurance, do nothing and you will automatically be billed each semester.

Reminder

Students are required to submit proof of health insurance for each fall semester that they attend.  Complete your waiver online at www.studentinsurance.com/Schools/NC/UNCP

Important

Certain students are exempt from the requirements and are not eligible to purchase the Student Health Insurance Plan.
 
If you fall into one of the following and would like to purchase health insurance, you can call Pearce & Pearce at 1-888-722-1668 for other coverage options.

                Exempt:

                *Distance Education Students

                *Online Students

                *Students taking less than 6 credit hours

If you have any questions, please contact Student Health Services at 910-521-6219.

 

Updated: Wednesday, December 12, 2012

 
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© The University of North Carolina at Pembroke
PO Box 1510 Pembroke, NC 28372-1510 • 910.521.6000