| 
Seminary Student and Dependent National Health Insurance Program
of the
Evangelical Lutheran Church in America
 View Current Policy and Rate Information (2004 -2005)
View 2005-2006 Policy and Rate Information
2004-2005 Policy
Also see the Insurance FAQ.
All eight ELCA Seminaries participate in the same student health insurance program. All students who are registered for more than seven course credit hours per semester and interns are required to participate in the program. If the student has “Other Group Coverage” as defined in the plan, the coverage can be waived by payment of a $250 access fee. The Business office must receive the waiver form by July 1, 2003 or the full insurance premium will be automatically billed to your student account. The Seminary Student Health Insurance Management Committee is established by the authority of the ELCA and its eight seminaries to oversee administration and operation of the Seminary Student National Health Insurance Program. The voting members consist of representatives from the Division for Ministry, presidents of ELCA seminaries and other representatives. The advisory members consist of one student representative from each ELCA seminary and others.
Please note the coverage amounts of eligible expenses under the major medical after the $200 deductible ($100 for optional spouse and dependent plan) up to an aggregate amount of $100,000 for any covered Injury or Sickness. There is also an optional plan available for coverage beyond this limit. There is optional excess coverage available to increase this $100,000 limit up to $200,000.
Please note the following summary information about the plan. Additional information is available in the plan brochure:
Insurance Company Boston Mutual Life Insurance Company
Plan Administrator Diversified Group Administrators
Claims Questions 800-427-9308
Plan Manager Specialty Risk Group
General Questions 877-581-2672
www.specrisk.com
Email: rlinde@new.rr.com
For details of plan benefits, please refer to the brochures distributed to students or visit the ELCA Board of Pensions website: http://www.elcabop.org/resources_tools/seminarian/student_benefits.asp
Preferred Provider Network Coalition of America is the preferred provider network available to insureds. Benefits will be paid at the negotiated rate for the participating providers. Students should visit the website of www.coalitionamerica.com/ (click on the online Provider Now button on the right, insert pin #3083).
Students can also use http://www.beechstreet.com
Prescription Drugs Prescription drugs will be offered through Walgreen's Health
Initiatives. Insureds will receive a drug card, separate from their insurance card. Co-pays for prescription drugs are $10, $15 and $30. Insureds must fill prescriptions at participating provider to receive this benefit. A list of participating pharmacies is available at www.whphi.com. Enter the Group
number from the Pharmacy card #516254.
Annual Premium for health plan
Student Cost – Annual $1,792/yr $896 for 09/1/2003 to 03/01/2004 due 08/15/2003
$896 for 03/01/2004 to 08/31/2004 due 2/01/2004
Dependent Spouse Cost – Annual $2,704/yr
Dependent Children Cost Annual $1,728/yr
Please note that coverage doesn’t begin until the premium is paid. This can take up to six weeks to fully process enrollment into the plan. Students and their dependents will have the option of increasing the maximum benefits from $100,000 to $200,000 for students and dependents may go from $50,000 to $200,000, the optional coverage is available for purchase with the following annual premiums:
Students Cost – Annual $146.00
Dependent Spouse – Annual $208.00
Dependent Child – Annual $208.00
Claim Forms
The most common reason for a claim not being paid is the failure of the insured to file a claim form. This is required and if not done may result in the claim getting lost since the claims processor would be unable to match it up with the insured. A Claim form is available on-line at
http://www.elcabop.org/resources_tools/seminarian/student_benefits.asp
2005-2006 Policy
View Benefit Summary (PDF)
The rates for Seminary Student Health Insurance have been announced for 2005/2006. They reflect drastically rising health insurance costs and some plan changes designed to keep the costs down. Some changes have been made in the coverage for 2005/2006 including a yearly cap on prescription drugs of $3,000/yr and other changes.
The rates for 2005/2006 are:
Student full participation in the plan:
$2,512 per year or $1,256 per semester payable July 31 or August 15 for Fall 2005 and Feb 1, 2006 for Spring 2006
Student Health Insurance Access (Waiver) $250 payable July 31 or August 15 for Fall 2005 or for new eligibility
Spouse Coverage $3,110 yearly billed directly by Insurance Company after application and paid quarterly
Dependent coverage $1,988 yearly billed directly by Insurance company after application and paid quarterly
Post Graduate (post enrollment) $2,632 yearly billed directly by Insurance company after application and paid quarterly
Summer or Quarterly* rates are: 2004/2005 thru August 31, 2005 2005/2006 thru August 31, 2006
Student full participation $514 $628
Spouse Coverage $778 $778
Dependent coverage $497 $497
Post Graduate (post enrollment) $658 $658
* Summer or quarterly rates are available only for those who become newly eligible to request the insurance due to new enrollment or termination of other insurance coverage. Quarterly periods run from: Sept 1 to Nov 30; December 1 to February 28; March 1 to May 31; June 1 to August 31.
The brochure and fact sheet should be available within several weeks on
The ECLA Board of Pensions Website http://www.elcabop.org/resources_tools/seminarian/student_benefits.asp
Or our representative’s website: http://www.specrisk.com/ELCA/index.html
|
