1. Student Health Insurance FALL 2014 Underwritten by: Blue Cross and Blue Shield of Illinois and Academic Health Plans

2. ACA (Affordable Care Act)  All students taking an On-Campus, Blended or Hybrid course must provide proof of insurance that meets the standards of the ACA.  For International students it is typically necessary to purchase the University sponsored Student Insurance Plan since the guidelines of the ACA now mandate an ‘UNLIMITED’ dollar amount of domestic medical coverage.

3. Cost  $410 for UIS Student Insurance is automatically charged to Student Accounts!  There is no paperwork to complete in order to enroll.  Dependents/Spouses are eligible for enrollment via a separate form and fee, payable directly to Blue Cross using the Dependent Enrollment Form, available at www.myahpcare.com/uis www.myahpcare.com/uis

4. Coverage Dates  * August 16, 2014-January 09, 2015 for Fall  January 10, 2015-May 31, 2015 for Spring  June 1-August 15, 2015 for Summer (you must take an On-Campus course to be automatically enrolled)

5. Correct Address is Important!  Please update your mailing address via Student Self-Service in Enterprise as soon as your housing becomes available! Blue Cross Blue Shield will mail an insurance card directly to you!  If your mailing address is not correct in UIS Enterprise, Blue Cross will mail your insurance card to Human Resources. You will be contacted by email to pick up.

6. Plan Benefits  Injury and sickness maximum benefit ’UNLIMITED’ per person per academic year  Hospital Expenses  Doctor’s Visits (including Vaccinations required by the Affordable Care Act)  X-rays  Ambulance  Emergency Room

7. DEDUCTIBLE  Deductible-What you must pay out of pocket before the insurance company begins to pay at 80%.

8.  Benefits will be paid by the insurance company at 80% after deductible of $400 annually has been paid by student out of pocket. For example:  Student A has X-rays totaling $800  Hospital bills the insurance company  Insurance company applies $400 of $800 bill to student’s deductible. Deductible is now satisfied.  Student pays $400 deductible amount to hospital.  Remaining $400 paid by insurance at 80% ($320 paid by insurance company).  Remaining 20% ($80 owed by student).

9. X-raysHospital bills sent to Insurance Company

10. Insurance company applies $400 of $800 bill to student’s Deductible. Deductible is now satisfied. Blue Cross Blue Shield

11. Student now owes first $400 Deductible amount to hospital

12. Pays 80%

13. Pays remaining 20%

14. Limited Dental & Vision Coverage  Excluded- cavity fillings, dental exams, cleanings, dental X-rays  Excluded but Discounted - eye exams, contacts, glasses through Davis Vision- https://www.blue365deals.com/daily_deals/112991 https://www.blue365deals.com/daily_deals/112991  Only an injury/sickness of the eye is included. Partially bony, impacted wisdom teeth is included.

15. Medical Facilities  Campus Health Services -does not directly bill insurance. Obtain a Walk-Out statement and send along with copy of your student account bill to Blue Cross.  St. John’s Hospital or any of its prompt care facilities -directly bills insurance  Memorial Hospital or any of its prompt care facilities -directly bills insurance

16. Prescriptions  Must use participating pharmacy such as Wal-Mart, Walgreens  $10 Co-payment for generic drug  $20 Co-payment for preferred brand  Locate a participating pharmacy by calling 800-423-1973 or online at uis.myahpcare.com

17.  QUESTIONS ARE WELCOMED