UConn RFP#CDR083126 Min Coverage and Plan Design.pdf
PDF 33 KB Posted
- Attached to
- Student Health Insurance Plan
- Solicitation number
- CDR083126
- Issued by
- Connecticut
About this file
This document is a minimum coverage and plan design requirements specification for the University of Connecticut's Student Health Insurance Plan RFP# CDR083126, applicable to proposals for the 2027-28 academic year. The University of Connecticut seeks qualified student health insurance providers to deliver a comprehensive plan offering 24/7/365 worldwide coverage that terminates at the end of the policy period or upon military service entry. Coverage must comply with all federal and Connecticut insurance mandates and include a PPO network option with at least 75% of area providers within a 20-minute drive of each campus, specifically including Windham Community Memorial Hospital, Eastern Connecticut Health Network, and UCONN Health in Farmington. The plan must provide primary coverage except where Connecticut State Law precludes payment obligation, short-term coverage for teaching and research assistants during the state's enrollment waiting period, and enrollment periods occurring in summer/fall and winter/spring with open enrollment for specific programs including UCAELI, visiting scholars, study abroad, and certificate programs.
The plan establishes minimum financial parameters including an in-network deductible of $300 individual/$900 family and out-of-network deductible of $600 individual/$1,800 family, with in-network coinsurance at 80% of negotiated charges and out-of-network coinsurance at 60% of usual and customary rates. In-network out-of-pocket maximums are capped at $6,850 individual/$13,700 family with no out-of-network maximum, and there is no overall maximum dollar limit per insured person per policy year. Coverage and costs for part-time students must match those of full-time students, with part-time students and voluntary enrollees applying and submitting payment directly to the insurance company. Optional coverage for spouses and dependents is available, and the plan must include repatriation and medical evacuation benefits for foreign students and UConn students studying abroad, with compliance to Federal J-1 Visa requirements. The insurer's total charges to students must include an administrative fee determined by the University to offset plan administration expenses.
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UConn Student Health Insurance Plan
RFP# CDR083126
Minimum Coverage and Plan Design Requirements
Plan Design Element Minimum Requirement
Coverage
Coverage and benefits must be 24 hours a day, 7 days a week, 52 weeks a year, worldwide, and will terminate at the end of the period for which the premium is paid or upon entry into the military service. The policy period will match the contract term.
If treatment is sought for a covered injury or illness during the policy period, benefits will be extended for 30 days, if the student or dependent is no longer eligible to re-enroll.
Coverage
Must comply with all Federal and Connecticut insurance mandates regarding coverage and benefit levels at the time of filing.
PPO Network:
Plan must include a PPO option with a network that includes at least 75% of area providers (within a 20-minute drive of each campus). Windham Community Memorial Hospital, Eastern
Connecticut Health Network, and UCONN Health (Farmington) must be included in the network.
Primary Coverage
Coverage on a primary basis except where there is no legal obligation to pay per Connecticut State Law (example – worker’s compensation).
Short Term Coverage
The plan must provide a short term coverage program for teaching assistants and research assistants (approximately two weeks for the first or second semester) during the State’s enrollment waiting period for its comprehensive employee plans.
Enrollment Periods
Will occur in the summer/fall for the fall semester and winter/spring for the spring semester, with an open enrollment period for specific programs. (Programs with variable terms and other open enrollment periods include the UCAELI
(University of Connecticut American English Language
Institute) program, visiting scholars, Study Abroad, and
Master’s Entry into Nursing and Teaching Certificate programs.)
Maximum benefit No overall maximum dollar limit per insured person, per policy year
In-network deductible $300 per person, per policy year
In-network family deductible $900 for all in family, per policy year
Out-of-network deductible $600 per person, per policy year
Out-of-network family deductible $1,800 for all in family, per policy year
In-network coinsurance 80% of negotiated charge
Out-of-network coinsurance 60% of usual and customary
In-network OOP maximum $6,850 individual / $13,700 family
Out-of-network OOP maximum No maximum
Full-time / part-time students
Coverage and cost for part-time students be the same as the insurance for the full-time students
Part-time students
Part-time students and voluntary enrollees will apply and submit payment directly to the insurance company for admission to the accident and sickness insurance program.
Spouse/Dependent
Benefits
Optional coverage for spouses and dependents of eligible students
Repatriation/Evacuation
Benefits
Repatriation and Medical Evacuation Benefits for foreign students studying at a UConn campus or UConn students studying abroad
International Students Compliance with Federal J-1 Visa, and all other applicable requirements for international students
Administrative Fee
The insurer’s total charges to the student must include an administrative fee to oFset the University’s expenses of plan administration in an amount as determined by the University and communicated in a timely fashion to the insurer.
File details come from the government source that posted it. Updated .