July 19, 2021 We are enhancing coverage for students enrolled in the Student Health Plan (SHP), who are going on a leave of absence and do not have access to comparable coverage, effective with the new plan year (August 1, 2021). Students taking a leave of absence for any reason (and not just for a medical reason) who do not have access to comparable health insurance while on leave will be able to receive a six-month extension of the SHP at no additional cost and will also be able to purchase up to six additional months of coverage beyond the no-cost extension at the normal student rate. Effective August 1, 2021, the Student Health Plan (SHP) will provide coverage for students who are on the SHP, are taking an approved leave of absence, and who do not have access to comparable coverage. Under this new coverage, student enrollees, whether graduate or undergraduate, who are on an approved medical leave of absence or any other approved leave of absence and who do not have access to comparable coverage may continue SHP coverage for a period of up to 12 months, in two six-month increments, starting on the date of the approved leave. Coverage for the first six months will be provided at no expense to student enrollees. Eligible students must complete the application and attestation process within 45 days after the date of the approved leave. Coverage for an additional six months will be available to the student enrollee as long as application, attestation, and payment for the coverage is received by the SHP Office at least 45 days before the end of the first six-month period. Students will have the option to pay in advance. If not paid in advance, the full 6-month amount will be billed to students on their Student Account, which will be due in the month billed. If this provides a hardship, the student can arrange for monthly installments with the Student Accounts Office. Learn more about: Approved Leaves of Absence Required Application and Attestation Process Cost for Extension of Coverage Subsequent Leaves Coverage for Dependents Prescription Coverage Vision and Dental Coverage 90-Day Coverage due to Medical Disability (including cost and dependent coverage) Contact for Questions Approved Leaves of Absence Graduate Students Graduate students should consult with their department advisor/DGS as well as a member of the academic affairs staff at the Graduate School. Additional information is available here. Undergraduate Students Undergraduate students should first consult with their residential dean to initiate the leave of absence. Additional information about leaves can be found on the Time Away from Princeton website. Required Application and Attestation Process Extension of coverage for an approved student leave of absence without comparable coverage requires that a student enrollee be on an approved leave. Once the student is approved for their leave, they must apply for coverage and attest that they do not have comparable coverage available to them within 45 days of the official date of their leave. This application and attestation process must be electronically submitted through the MyUHS online portal. For the subsequent six-month period, the application and attestation must be completed at least 45 days before the end of the first six-month period. Students will have the option to pay in advance. If not paid in advance, the full 6-month amount will be billed to students on their Student Account, which will be due in the month billed. If this provides a hardship, the student can arrange for monthly installments with the Student Accounts Office. Cost for Extension of Coverage During the Plan Year August 1, 2021 to July 31, 2022, for all approved student leave of absence without comparable coverage to the SHP and for their eligible dependents, rates* for the second six months will be as follows: First 6 Month Extension Rate Second 6 Month Extension Rate Student $0 $1,390 Spouse $1,100 $1,100 Child $550 $550 Children (2) $1,100 $1,100 Children (3+) $1,650 $1,650 *If a six-month extension continues into the next plan year, the six-month extension fee may be adjusted based on the next plan year fee schedule, if applicable, and include the application of new plan year deductibles. Subsequent Leaves For subsequent approved leaves of absence, enrollees may extend coverage for an additional two six-month periods at their expense (for a total of 24-months over their time at Princeton), as long as they are enrolled in the plan at the time of the subsequent leave and do not have access to comparable coverage. Coverage for Dependents Dependents on the SHP are able to extend coverage if their affiliated student is taking an approved leave and does not have comparable coverage. They must complete the required application and payment of fees within 45 days of the approved leave date. Eligible dependents include a student’s spouse and eligible children up to 26 years of age (including stepchildren, foster children, and legally adopted children), provided the student is fully enrolled and eligible for coverage. Prescription Coverage The prescription plan is considered part of the Student Health Plan. While on leave, a student that extends coverage on the SHP will also have their prescription coverage extended. Vision and Dental Coverage For students that have already enrolled in dental and/or vision coverage, their coverage will continue for the period for which they have enrolled. At the end of the period of enrollment in the dental and/or vision coverage, these benefits will terminate. Vision and dental coverage are separate and apart from the Student Health Plan, and are not part of the extension of coverage for an approved student leave of absence without comparable coverage. 90-Day Extension of Coverage due to Medical Disability The SHP previously offered, and will continue to offer, a 90-day extension of coverage to enrolled students who are undergoing treatment when their coverage is being terminated. This applies to all students, including those who are graduating. Under this existing benefit, coverage continues if a student enrollee is medically disabled or becomes confined to a hospital or is undergoing specialty treatment for an identified condition and this condition has been documented in the student’s medical records by the providers at University Health Services within 30 days prior to the termination of the SHP. The condition must be due to an accidental bodily injury or illness incurred before the coverage would have terminated. Such coverage continues, subject to the provisions of the SHP for treatment of the disabling condition, until 90 days after the date of normal termination of coverage. Coverage for the additional 90 days is available to the enrollee as long as payment for the coverage is received by the SHP Office within 30 days prior to the termination of the SHP. If the 90-day extension continues into the next plan year, the 90-day fee may be adjusted based on the next plan year fee schedule, and include the application of new plan year deductibles. A 90-day Extension of Coverage due to a Medical Disability is available for a student enrollee (and any eligible dependent enrollee) who meets the following criteria: a student enrollee with an identified medical disability or becomes confined to a hospital or is undergoing specialty treatment for an identified condition and this condition has been documented in the student’s medical records by University Health Services within 30 days prior to the termination of the SHP; with or without comparable coverage; and not planning on returning to the university (example - graduating status). Comparatively, an Extension of Coverage for Approved Student Leave of Absence Without Comparable Coverage is available for a student enrollee (and any dependent enrollee) who meets the following criteria: must have an identified approved leave status; without comparable insurance; and planning to return to the university to pursue their education. Cost for 90-day Extension of Coverage Due to Medical Disability 90-Day Extension Rates* Student $695 Spouse $550 Child $275 Children (2) $550 Children (3) $825 *90 days is the maximum coverage available to students and their eligible dependents on the SHP. If the 90-day extension continues into the next plan year, rates may vary. 90-Day Coverage for Dependents Dependents also have access to coverage 90-day Extension Due to Medical Disability if they have completed the required application and payment of fees. Contact for Questions If you have questions about the new SHP Extension of Coverage or about coverage for other specific benefits and services, contact Aetna by calling 1-877-437-6511. You may also email the SHP Office at [email protected].
