Pomona College requires that all students carry adequate health insurance, that will be accessible in Claremont and comparable to The Claremont Colleges health insurance plan. We recognize insurance can be a complex topic and many students and families have questions about whether to continue with SHIP or to waive out. Here are some of the most common concerns we hear from students and families.
What is SHIP?
SHIP is a health insurance plan designed just for students enrolled at The Claremont Colleges. Your school makes this plan available to protect your educational future. If you get sick or injured, insufficient health insurance can lead to financial hardships that can threaten your ability to attend class, pay tuition, get student loans, or live away from home. Having health insurance is a safety net that helps ensure you are able to stay in school so you can graduate and achieve your professional goals. SHIP is available to all Pomona College students.
Note: Student Health Services (SHS) is available to all students regardless of type of insurance coverage.
Am I required to have health insurance?
Any continuing students or newly matriculated students at Pomona College are required to have adequate health insurance coverage. You will be automatically enrolled in SHIP, unless you provide proof of comparable coverage and submit a waiver by the Waiver Deadline September 1, 2020. If you have other health insurance, such as coverage under your parent’s or employer’s insurance plan, and you do not wish to enroll in SHIP, you may submit a waiver application. International students are required to have SHIP coverage and are not allowed to waive out of the plan.
Can I afford SHIP?
SHIP costs $2655 for a full year (12 months) of coverage (August 2020-August 2021). All students enrolled in SHIP who receive Pomona College financial aid will be automatically be packaged with a Pomona Medical Grant to cover half the cost of the health insurance($1,327.50). Students may request a loan to cover half of the cost of the health insurance ($1,327.50). Students who are not receiving financial aid or any student requesting a loan should send an email to the Office of Financial Aid.
Will I still be able to see my doctors back home?
The SHIP insurance carrier is Aetna EPO, which is a large, well-established, nationally recognized insurance company. To check whether your provider is listed as an “in-network” provider, please call Aetna student health customer service at 1-877-480-4161 and ask if your specific provider is included. You may also go to www.aetnastudenthealth.com to see if your provider is listed as being “in-network”.
What does SHIP cover? Is it different from using the on-campus health services?
Regardless of insurance, all Pomona College students have access to the Claremont Consortium’s on-campus Student Health Services (SHS) for medical needs as well as Monsour Counseling and Psychological Services (MCAPS) for mental health needs. Services at MCAPS are free. Scheduled appointments at SHS are free, however fees may be charged for services depending upon the type of treatment you receive, and all students are responsible for submitting medical claims to their insurance directly (including students with SHIP). SHIP is a comprehensive medical plan that also includes some vision and dental benefits (up to age 19). Some highlights of SHIP coverage include coverage to see both primary care providers and specialists, ambulance transport, x-rays, lab tests, surgery, urgent and emergency care, overnight hospital stays, mental health and substance abuse treatment and prescription drugs. Refer to the SHIP website for a complete description of the insurance plan.
What is a health insurance waiver application?
A health insurance waiver application is an online form that you fill out if you have other qualifying health insurance and do not wish to be enrolled in SHIP. As part of the waiver process you are required to provide specific information about your insurance coverage, which will be verified by Relation Insurance Services, the Waiver Administrator for Pomona College.
Does my other insurance qualify?
If you wish to waive SHIP because you have other insurance, benefits under that plan must include all of the following:
- Coverage must be effective on or before 8/30/2020 (8/01/2020 for new students) and must be continuous (no break or termination) for the entire academic year;
- Maximum benefit must be unlimited;
- Deductible must be $1,000 or less ($2,000 per family) per policy year (see note below);
- For international students, at least $25,000 of repatriation coverage and $50,000 of medical evacuation coverage; and
- Claims must be paid by a U.S.-based company, and underwriting company must be owned, operated, and headquartered in the U.S. and must be in full compliance with all applicable federal laws. International students may not waive with insurance from their home country.
Note: If you do not meet the deductible requirement, you must submit a High Deductible Petition form after a waiver is submitted. To download a form, visit www.4studenthealth.com/pomona.
Your insurance coverage will be verified. Students who are covered under a health insurance plan that does not meet all of the applicable requirements will not be allowed to waive out of SHIP.
How do I decide whether or not to waive SHIP?
If you have other coverage that meets the waiver criteria, it is your decision whether or not to waive. However, before you make that decision, please consider the following:
- SHIP may be less expensive than being insured on an individual plan or as a dependent on an employer group plan through your parent or spouse. When comparing costs, be sure to look at premium, deductibles, copays, and out-of-pocket maximums.
- SHIP has a local EPO provider network. If you have out-of-state coverage, or HMO or PPO coverage with a limited provider area, there may not be many or any network providers near school. You may have to pay higher out-of-network copays, deductibles, or coinsurance.
Please remember that if you waive coverage under SHIP, you are responsible for any medical costs you incur.
How often do I have to submit a waiver application?
Students who wish to waive out of SHIP must complete the online application each academic year by the deadline date.
What happens if I don’t waive by the deadline date?
Students who do not submit a waiver application by the deadline date stated above will be automatically enrolled in SHIP, and you will have to wait until the next waiver period to waive out of SHIP. No refunds will be issued.
If my insurance coverage starts after the term begins, can I get a refund?
If it is past the waiver deadline date, your SHIP coverage will remain in place and you will have to wait until the next waiver period to waive out of SHIP. No refunds will be issued.
What if I successfully waive out of SHIP, then lose my other coverage?
You may enroll in SHIP mid-year if you waived out but later lose your other coverage due to no fault of your own, such as coverage that terminates due to a loss of employment (by you, your spouse, or your parent) or by reaching an age limit set by the plan. This does not include coverage that has been voluntarily or inadvertently terminated by you, for example, by missing an enrollment deadline.
To enroll in the plan mid-year after an involuntary loss of coverage, you must notify the Dean of Students Office on campus and submit proof of loss of coverage within 31 days of termination of prior coverage. Premium costs will be prorated based on number of full months remaining in the term. Contact Relation Insurance Services Customer Service at (800) 537-1777 for an enrollment form or additional information.
How do I submit a waiver application?
To submit a waiver application, have a copy of your insurance card ready, and follow these steps:
- Go to www.4studenthealth.com/pomona and click on the “Waive Out of SHIP” icon.
- Once on the waiver portal page, enter your last name, date of birth (DOB), and student ID number, then click “Login.”
- On the next page, where the term of coverage is indicated as “Available to waive,” click “Create.”
- Please read the text on the next page, then check the “I understand and agree...” box if you agree to the terms and conditions, and click “Continue.”
- If you submitted an approved waiver in the previous term, your prior insurance information will be shown. If your information has not changed from last term, go to step #7 below.
- If your insurance information has changed, or you do not have an approved waiver on record, you will be asked for information about your insurance plan. Please enter your information exactly as it appears on your insurance ID card. See chart at right for definitions of terms.
- Click “Submit Petition.” Shortly after you click Submit, you will receive an email confirming receipt of your information.
How do I know if my waiver is approved or denied?
When you submit a waiver application, you will receive two emails, the first is a “SHIP Waiver Confirmation” email via your student email account, the second is a “Waiver Approval” or “Waiver Denial” email a couple of days after you receive the first email. Your waiver is not complete until you receive a “Waiver Approval” or “Waiver Denial” email message. Please check your student email account regularly for waiver status updates.
Approval of your waiver means that you will not be enrolled in SHIP for the 2020–2021 academic year and that medical costs you incur will be your responsibility. Pomona College reserves the right to verify your eligibility status. If at any time it is discovered that you have failed to maintain coverage that meets the stated requirements, your waiver will be revoked and you will be required to enroll in SHIP.
If your waiver is denied, you will receive a “Waiver Denial” email and you will be automatically enrolled in and charged for the school sponsored plan.
Appealing a waiver denial
If you would like to challenge your waiver denial, you may contact the Dean of Students Office to submit an appeal. Appeals must be received within 7 business days of your waiver denial notification to be considered.
What happens if I receive an “Action Required” or “Information Needed” email?
If you receive an “Action Required” or “Information Needed” email, you must provide the requested information, or your waiver will be denied. If you provide the information and it meets the requirements, you will be notified via your student email account within 3–10 business days that your waiver was approved. If you do not provide the information by the date requested, or if the documentation you provide does not meet the requirements, you will be automatically enrolled in SHIP and you will receive notice after the waiver deadline that your waiver application was denied.
It is your responsibility to check your student email account for waiver status updates and to send in additional documentation if requested.
Whom should I contact if I have additional questions?
For more information or questions about waivers, please contact Relation Insurance Services, the Waiver Administrator, at (800) 537-1777, or email customer service at firstname.lastname@example.org.
Definition of Terms
Insurance Co. Name: This is the name of the insurance carrier. Please select from the drop-down box. If your insurance carrier is not listed, please select “Other” and enter the full name of the company.
Insurance Co. Phone: This is the customer service or provider phone number, usually found on your insurance ID card or the insurance company website, which we can call in order to verify that the information you have provided is accurate.
Primary Insured First: This is the first name of the individual who is the primary insured on the plan. If you are insured through your parents, it’s either your mother or your father, depending on whose plan it is. If you are insured through your own employer, it’s your name. If you are covered under your spouse’s insurance plan, it’s your spouse’s name. It may also be listed as Subscriber, Member, or Enrollee on the insurance card.
Primary Insured Last: This is the last name or surname of the individual who is the primary insured on the plan.
Primary Insured DOB: This is the date of birth of the individual who is the primary insured on the plan.
Relationship to Primary Insured: This is the student’s relationship to the primary insured. Please choose Self, Spouse (if your spouse is the primary insured), Child (if your parent is the primary insured), or Other Adult (if the primary insured is not yourself, spouse, or parent).
Policy/Group Number: This is a number found on the insurance ID card of your current health plan. It is different from the member number. It will be listed as Policy or Group Number and may contain an alpha prefix (letters, then numbers). Type it in exactly as it appears on the card.
Member/Sub ID: This is a number found on the insurance ID card of your current health plan, sometimes referred to as a member or subscriber ID. It is different from the policy or group number. It is sometimes the Social Security Number of the policyholder. Type it in exactly as it appears on the card.
Primary Insured Address: This is the address of the individual who is the primary insured on the plan.
Most of this information can be found on the insurance ID card. Other information can generally be found on the insurance company’s website. If you are covered under an employer plan, the employee can contact their employer’s Human Resources department or benefits department or the insurance carrier.
Please make sure the information you provide on your waiver application is accurate, as incorrect or incomplete information may cause your waiver application to be denied. Information provided on waiver applications will be verified by Relation Insurance Services, the designated waiver administrator.