School Health Insurance

A private insurance company administers a low-cost Student Health Insurance Policy for Rhode Island College students. The administrator for the 2016-17 academic year is Outside LinkUniversity Health Plans, Inc. A copy of the brochure may be found through their website. The preferred provider group is the PHCS Provider Network (a division of MultiPlan) and the participating pharmacy network is OptumRx; for R.I. provider locations, please visit Outside Linkwww.phcs.com and for participating pharmacies visit Adobe PDFOutside Linkhttps://www.universityhealthplans.com/pdf/OptumRx_PharmacyNetwork-1617.pdf.

All undergraduate degree students pre-registered for 9 or more credits are automatically billed for the insurance. Students may opt to waive this coverage if they have comparable coverage. Procedures to waive the insurance are available through the Outside LinkUniversity Health Plans, Inc. website, Outside Linkwww.universityhealthplans.com.

FAILURE TO COMPLETE the on-line Waiver Form by the fall deadline, September 21, 2016, will result in your mandatory purchase of the College's Student Insurance Plan, without the possibility of later waiver, refund or cancellation. You will be able to waive out of the Student Insurance Plan by the deadline date of September 21, 2016 for both the Fall and Spring Semesters if you have other insurance coverage that will insure you for the entire Academic Year. The waiver deadline date for the Spring Semester is February 20, 2017.

International students are required to carry insurance and are automatically enrolled in the College's insurance plan, and may not waive it.

Part-time, non-degree, and graduate students enrolled in a minimum of six (6) credits hours may enroll in the Rhode Island College Student Health Insurance Plan on a voluntary basis. To purchase coverage, you may enroll on-line at Outside Linkwww.universityhealthplans.com and click on "Rhode Island College", then “Enrollment Form” and choose the option for the “Voluntary Student Enrollment Form”. The enrollment deadline date is September 21, 2016 for the Fall Semester, and February 20, 2017 for the Spring Semester (open to newly enrolled students only).
All students are strongly encouraged to carry medical insurance to cover unexpected emergencies and illnesses and to prevent disruption of educational goals due to catastrophic financial burdens.

Prescription Drug Benefits

After a co-payment of $15 for generic or $35 for a brand name drug (per 30 day prescription) the cost of prescription drugs is payable in full up to the plan maximum for the policy year (when filled at a participating pharmacy). Generic Contraceptives are covered with no co-payment. Prescriptions must be filled at an OptumRx participating pharmacy. Insured persons will be given access to an online PDF copy of their health insurance card to use for medical appointments and to use at a participating pharmacy.

Mail Order Prescription Drugs

Rhode Island College students may order maintenance medications (those that are taken for long periods, such as for heart disease, high blood pressure, asthma, etc) through mail order. After a co-payment of $30 for generic or $70 for a brand name drug (per 90 day prescription) the cost of prescription drugs is payable in full up to the plan maximum for the policy year. Because of volume buying, OptumRx, the mail order pharmacy, is able to offer Covered Persons significant savings on their prescriptions.

How to fill a Prescription

Preferred Care:

When obtaining a covered prescription, you should present your Student Health Insurance ID card to the OptumRx participating pharmacy, along with their applicable Coinsurance payment. The pharmacy will bill OptumRx for the cost of the drug, less the copay or coinsurance amount.
When you need to fill a prescription and do not have your ID card, you may obtain your prescription from a OptumRx participating pharmacy, and be reimbursed for covered medications by submitting a completed OptumRx Prescription Drug claim form. A claim form is available by visiting Outside Linkwww.universityhealthplans.com. Click on "Rhode Island College" and you will see the claim form under “Prescription Information 2016/17 Policy Year” on the left -hand side of the page. You will be reimbursed for covered medications directly by OptumRx.

Non-Preferred Care:

Prescriptions will not be covered if filled at an out-of-network pharmacy.
The Rhode Island College (RIC) Student Health Insurance Program includes coverage for asthma and allergy medications including inhalers and diabetic supplies such as insulin and syringes. All FDA approved prescription contraceptive drugs and devices are also covered through OptumRx. Not all medications are covered. Please contact Consolidated Health Plans at 1-800-633-7867 or visit Adobe PDFOutside Linkhttps://www.universityhealthplans.com/pdf/OptumRx_FormularyGuide-1617.pdf for more details.

Frequently Asked Questions

Q: Who is the insurance carrier and what is the policy number? 
A: The 2016-2017 Student Health Insurance Plan is underwritten by National Guardian Life Insurance Company and the Policy Number is 2016I5B34.

Q: What is the effective date?
A: The effective date of the policy is August 15, 2016. If you purchase coverage for the spring semester only, your effective date of coverage is January 15, 2017.

Q: What is the policy expiration date?
A: The policy expires at midnight August 14, 2017. If you purchase coverage for the fall semester only, your coverage would expire at midnight January 14, 2017.

Q: How do I obtain coverage under the Student Health Insurance Policy?
A: All undergraduate students taking 9 or more credit hours at the time of initial fall or spring enrollment are automatically enrolled and the cost of the insurance is included on your tuition bill. Full-time undergraduates will be allowed to waive the insurance if they have comparable coverage elsewhere.
Coverage may be waived by visiting Outside Linkwww.universityhealthplans.com and selecting "Rhode Island College" from the menu. Further instructions on how to waive are provided at this web address. Please note that the Fall semester waiver deadline date is September 21, 2016. The waiver deadline date for Spring Semester is February 20, 2017.
All international students are required to carry insurance and are automatically enrolled in the College's insurance plan and may not waive out of it.
Part-time, non-degree, and graduate students enrolled in a minimum of six (6) credit hours may enroll in the Rhode Island College Student Health Insurance Plan on a voluntary basis. To purchase coverage, you may enroll on-line at Outside Linkwww.universityhealthplans.com and click on "Rhode Island College", then “Enrollment Form” and then choose the option for “Voluntary Student Enrollment Form” on the left hand side of the page. The enrollment deadline date is September 21, 2016 for the Fall Semester, and February 20, 2017 for the Spring Semester (open to newly enrolled students only).
All students are strongly encouraged to carry medical insurance to cover unexpected emergencies and illnesses and to prevent disruption of educational goals due to catastrophic financial burdens.

Q: Can I get the insurance to cover my spouse and/or children?
A: No, dependent coverage is no longer available under the Rhode Island College Student Health Insurance Plan. Students in need of coverage for their dependents should investigate what non-group policies are available in Rhode Island.

Q: What does this insurance cover?
A: This insurance covers medical expenses which arise from an accidental Injury or Sickness which occurs while you are covered under this program.

Q: Does this policy pay all medical bills in full?
A: In most circumstances it will not. There are deductibles, coverage limitations and exclusions in the policy....refer to the brochure available on-line for more details. The brochure can be viewed at Outside Linkwww.universityhealthplans.com and click on “Rhode Island College”.

Q: Can I go to any doctor?
A: Yes you can. However the 2016-2017 Student Health Insurance Plan includes access to the PHCS Provider Network (a division of MultiPlan). By using a Preferred Provider, students will lower their out-of-pocket expenses and extend the overall benefits available under the plan. A listing of preferred providers can be accessed by visiting Outside Linkwww.multiplan.com/search or by calling toll-free 1-866-559-7427.  If you visit an off-campus provider, please call RIC Health Services at (401) 456-8055 so a referral can be submitted electronically.

Q: Where do I get a Claim Form?
A: You can pick up a Claim Form at the College's Student Health Center. Also both medical and prescription drug claim forms are available at Outside Linkwww.universityhealthplans.com

Q: How do I file a claim?
A: The following instructions are for filing a medical claim. Instructions for filing a prescription drug claim are detailed under the Prescription Drug section of this FAQ.

  • Bills must be submitted within 90 days from the date of treatment.
  • Payment for Covered Medical Expenses will be made directly to the hospital or Physician concerned unless bill receipts and proof of payment are submitted.
  • Subsequent medical bills should be mailed promptly to Consolidated Health Plans.

All medical bills should be submitted to the Claims Administrator shown below:
Claims Administrator
Consolidated Health Plans
2077 Roosevelt Avenue
Springfield, MA 01104
Local: (413) 733-4540
Toll Free (800) 633-7867

Q: Does this policy cover me for my annual physicals?
A: We will cover one annual physical exam, 100% of the PPO Allowance, not subject to the policy deductible. If received out-of-network with no health center referral benefits are payable at 70% of the R&C Rate.  With a referral out-of-network benefits will increase to 80% of the R&C Rate.

Q: Is there a deductible on this policy?
A: Yes. A $100 deductible for each Injury or Sickness applies (waived if referred by the SHC). The following services are subject to a per visit copay:

  • Physician Office Visit - $15 copay per visit until the $100 deductible maximum has been met.
  • Emergency Room Visit - $50 copay per visit.
  • Lab Work - $15 copay per visit.

Q: With this insurance must I go to the College's Student Health Center first?
A: To maximize benefits, insured students must use the resources of the College's Student Health Center when first seeking medical treatment. Treatment will either be administered at the Health Center or a referral to another facility will be given. Expenses incurred for medical treatment received outside of the Health Center without prior approval or referral are subject to reduced benefits from 80% R&C to 70% R&C. Please review the Student Health Service section of the insurance brochure for exceptions.

Q: What if I am out of state when I get sick or injured:
A: The insurance plan will cover you for any illness or Injury which occurs out of state. You must follow the same procedures in filing a claim as if it had happened in Rhode Island.

Q: How do I get an I.D. Card? A: The school will be sending University Health Plans a list of all students enrolled in the insurance plan. University Health Plans will provide that list to Consolidated Health Plans who will send out an email to each student with instructions to access and print a PDF copy of their member I.D. Card. You may also download a PDF of your insurance ID Card by visiting Outside Linkwww.consolidatedhealthplan.com, and selecting Rhode Island College from the menu.

Q: If I have a specific question about coverage who can I call?
A: You can call University Health Plans at 1-800-437-6448.

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Page last updated: Aug. 22, 2016