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Stony Brook University Stony Brook University Student Affairs
Student Health Service

SBU Health Insurance Plan Facts

HISTORY AND RATIONALE

Having health insurance encourages students to seek needed medical treatment for potentially infectious diseases, for mental health treatment and medications, and for other conditions that could otherwise have serious consequences to themselves and others in the community.

Student health insurance provides a level of safety to all students and to their peers.

The decision to require that full time Stony Brook students have health insurance was made by senior members of the Stony Brook University Administration, as authorized by the Trustees of the State University of New York.

Required student health insurance was formally proposed at Stony Brook University in 1999, by the committee responsible for reviewing student life issues; the concept was placed in the University's 2000-2005 Master Plan, which was widely distributed to the campus community at that time.

The committee raised the issues of individual right to accessibility of medical and mental health care, as well as the implication of lack of access on the community's health.

It was noted that even a visit to the Emergency Room of a hospital can cost between $200 and $1,000. After the visit, a student has follow-up physician visits, and testing, and sometimes even surgery. A very serious illness or injury can cost way beyond anyone's pocket book can afford (an average cost with in-patient hospitalization can be $15,000).

Input to the proposal/decision process was received from the campus Student Health Advisory Committee, largely composed of students. The Committee expressed concerns about the impact of health insurance cost on Stony Brook students. This and other concerns were seriously considered, and because of this, it was determined that financial aid may be applied towards our health insurance premiums.

Also included in the decision process was documentation of students with serious medical conditions (diagnosed by medical providers at the Student Health Center) who refused, to their medical detriment, to pursue necessary medical treatment outside the campus.

Input was also received from the University Counseling Center which had a waiting list of students who required mental health treatment, especially during periods of high stress. Students who wanted to seek treatment off campus would have to pay out of pocket.

Another factor considered during the decision process was that the voluntary health insurance plan, offered at Stony Brook for many years, was no longer able to meet the basic health insurance needs of our students. Small enrollment numbers and negative selection factors (students who were most likely to use the insurance plan comprised the majority of the ones enrolling), made it impossible to provide reasonable coverage at an affordable price. 

Once we began contacting insurance companies with our concept of a required insurance plan, we found we could offer $100,000 coverage per condition, instead of the old voluntary plan limit of only $25,000 per condition; yet the premium cost would remain the same. Coverage information can be accessed at: www.aetnastudenthealth.com/sbu 

We then researched other major public universities that require their students to have health insurance, including SUNY Buffalo, SUNY Binghamton, the University of Connecticut, the University of Massachusetts, Rutgers University, the University of Maryland, and the SUNY-wide Mandatory International Student Health Insurance Plan.

The Faculty Student Association (the University's auxiliary service corporation) was then asked to conduct an extensive bidding process during which proposals from over a dozen insurance providers were examined. The lowest possible premium for reasonable health insurance benefits was identified long before a final decision about offering required health insurance was reached by the University.  After many months of research and discussion, a final contract between the insurance company and FSA was signed, stating all the benefits to be offered to our students.

By comparison with the other Universities noted above, the plan the Committee decided to offer at Stony Brook is both comprehensive and cost effective. Our premiums, for the benefits offered, are lower than at most other Universities.

The University understands that no insurance plan can meet every student's needs but we believe the plan which has been selected, after extensive consideration, has already proven to be a benefit to most of our University community.

THE BILLING AND WAIVER PROCESS

All full time students are billed automatically for the health insurance plan when they register for classes.

A student who has comparable alternate health insurance may waive the University plan. He or she must waive on SOLAR by either 9/15 for fall, or by 2/15 for spring/summer. The SOLAR waiver takes only about 3 minutes to complete.

Usually no insurance proof is required at the time of the waiver.

In the event that a waiver is not granted, regardless of the reason, and a student wishes to appeal the decision, he or she may do so by completing a Request for Appeal of Waiver Denial form and submitting it to the Student Health Service Medical Director.

If the Medical Director denies an appeal based on medical factors, that decision will be final.
If the appeal is based on non-medical factors, the student may complete and submit a Request for Final Appeal of Waiver Denial form to the Student Health Insurance Appeals Committee through the FSA Customer Advocate.

This Committee is appointed by the Vice President of Student Affairs and is composed of three members, at least two of whom are students. None of the members of this Committee have duties otherwise related to the Student Health Insurance Office.

The Student Health Insurance Appeals Committee will make a determination and notify the student of its decision, with copies to the Offices of the Dean of Students and the FSA Executive Director. The decision of the Appeals Committee will be final in this matter.

AUDITS REQUIRED BY THE CONTRACT

Random audits are carried out every semester; these require the student to prove he has comparable health insurance. During this process the alternate insurance company will be contacted.

PREMIUMS BILLED, AND BENEFITS PAID BY THE AETNA PLAN

Premium for Fall 2014 (8-16-14 through 1-15-15): $975
Spouse: $2,911.75
Children: $1,472.25

Premium for Spring 2015 (1-16-15 through 8-15-15): $1,354.50
Spouse: $4,065.75
Children: $2,054.25

Coverage is generally for illnesses and accidents, needing the following medical services:

  • Physician office visits
  • Outpatient testing in labs
  • Radiology, such as Xrays, CAT scans, MRIs, etc.
  • Pharmacy medications
  • Inpatient hospitalization
  • Surgery
  • Mental health counseling
  • Yearly gyn and prostate examinations
  • And more

The following website contains complete information on the plan benefits, exclusions, network participants, a location to check on claims being processed, etc : www.aetnastudenthealth.com

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See www.stonybrook.edu/titleix for more information and/or to report an incident.