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Student insurance plan grandfathered out of ACA for now

Associate Editor

Published: Monday, January 20, 2014

Updated: Monday, January 20, 2014 23:01

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Regulations of the Affordable Care Act (ACA) have yet to change the face of health insurance offered at Sam Houston State University.

SHSU’s student health-insurance policy still has an annual dollar limit because the plan was grandfathered into exemption. However, annual dollar limits, which limit the amount of medical expenses insurers are responsible for paying each year, were eliminated by ACA after Jan. 1.

“We are fully compliant with ACA,” Academic Health Plans customer care center manager Jennifer Simpson said. “The school product is written on an academic school year. Schools generally start in August and go through the end of July. The academic policy year goes from August to August, not January to January.”

Simpson said since the plan runs on an academic school year, the company has yet to see the effects of ACA.

“Every university’s different,” Simpson said. The schools are the policy holders. They are the ones that drive what they want as for which benefits to include, other than obviously the mandated benefits.”

Annual plans that began before Jan. 1 are able to have limits until the plans expire, which is the case for SHSU’s student insurance plans. This means that regardless of when students pay or sign-up, they are covered only for the first $500,000 of medical expenses through Aug. 14, 2014, according to a joint publication by SHSU and BlueCross BlueShield of Texas.

Health coverage for SHSU students is provided by BlueCross BlueShield of Texas and is administered by Academic Health Plans.

Students who are enrolled for at least six or more credit hours can sign up for university’s healthcare plan.

One ACA-mandated benefit that is covered by the SHSU plan is free contraceptives.

The cost for SHSU student health insurance is dynamic and depends on marital status and the length of plans. Currently, for an annual plan for just a student, the price is $993. An additional spouse will cost an extra $2,270 per year and each child will add another $1,131.

Students may also purchase the plans in the summer or elect to pay for the plan for spring and summer combined. A plan for spring and summer will run at $707 for students, an additional $1,639 for spouses and $823 for any children. Coverage for only the summer will cost $270, with $629 being tacked on for a spouse and $316 for each child.

As mandated by ACA, every American must have health coverage starting Jan. 1. For more information, visit academichealthplans.com/shsu.

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