Plan year: August 18, 2006 - August 17, 2007

Student Gold Health Insurance Plan

Other Information

• Are any other benefits included in the Student Gold Health Insurance Plan?
• If I have discontinued another insurance program, but I am still receiving some benefits from that program, will my Student Gold Health Insurance Plan benefits be coordinated with that coverage?
• Who is the insurance underwriter of the Student Gold Health Insurance Plan?
• Are there any other benefits included Student Gold Health Insurance Plan?
• Where would I get more complete and detailed information on the Student Gold Health Insurance Plan?
• Are there benefits if the insurance plan year has expired for the Student Gold Health Insurance Plan?
• Are there conversion plans?

Are any other benefits included in the Student Gold Health Insurance Plan?
Benefits are provided as mandated by Colorado Department of Insurance such as congenital defects and birth abnormalities, hospitalization and general anesthesia for dental procedures for dependent children, hospice care, medical foods, prosthetic and orthotic devices benefits, telemedicine services, and cleft lip and cleft palate benefits. Details of these benefits may be found in the master policy on file at the university.

If I have discontinued another insurance program, but I am still receiving some benefits from that program, will my Student Gold Health Insurance Plan benefits be coordinated with that coverage?
If you were covered by a valid prior policy in the 31 days prior to obtaining the Student Health Insurance as a replacement, you will immediately be covered by the new policy. However, if the prior company is providing an extension of benefits for someone who is totally disabled on the date of discontinuance, the company will deduct the amount of those payments from the amounts payable under your new policy.

(“Totally disabled” refers to the person's status immediately prior to the effective date of the policy.)

An insured person who is eligible for this extension of benefits under the old policy shall be covered as long as the condition continues, not to exceed 90 days after the termination date.

Pre-existing conditions shall be limited to the lesser of a) the benefits of the policy without application of the pre-existing conditions, or b) the benefits of the prior policy.

At the request of the company, the prior company shall furnish a statement of benefits available or pertinent information, sufficient to permit verification of benefit determination by the company.

Where your new policy and previous policy have similar deductibles or benefit waiting periods, you will be given partial or total credit for these provisions where it provides similar benefits.

This provision will apply only for expenses actually incurred and applied against the deductible of the prior policy during the 90 days preceding the effective date of the new policy.

Who is the insurance underwriter of the Student Gold Health Insurance Plan?
Benefits provided outside of Wardenburg Health Center are underwritten by the MEGA Life and Health Insurance Company. Claims and inquiries to AmeriBen at 800-626-5520. The MEGA Life and Health Insurance Company booklet for 2006-07 will be sent to you when you enroll in the Student Gold Health Insurance Plan. It further describes the benefits, co-payments, limitations, exclusions, and special provisions of the plan.

Are there any other benefits included in Student Gold Health Insurance Plan?
Benefits provided outside of Wardenburg Health Center are underwritten by the MEGA Life and Health Insurance Company. Claims and inquiries to AmeriBen at 800-626-5520.

Where would I get more complete and detailed information on the Student Gold Health Insurance Plan?
The master policy of the Student Gold Health Insurance Plan is on file at the university and contains all of the provisions, limitations, exclusions, and qualifications of your plan, some of which may not be included on this website. The master policy is the contract and will govern and control the payment of benefits.

You may call the Student Health Plans Office at 303-492-5107. You can also stop by the office (Wardenburg Health Center, room 251). You can also get more information on the plan at www.studentresources.com. There you can view and print the MEGA Life and Health Insurance Company booklet. You may call AmeriBen for enrollment cards, coverage information, ID cards, claims status, and other services.

Are there benefits if the insurance plan year has expired for the Student Gold Health Insurance Plan?
The coverage provided under the Student Health Insurance Plan ceases on your health insurance plan year end date. However, if you are confined to the hospital on the termination date due to a covered injury or sickness for which benefits were incurred before your termination date, the covered medical expenses for that injury or sickness will continue to be paid as long as the condition continues, but not to exceed 90 days after your termination date.

The total payments made in respect of the insured for such condition both before and after the termination date will never exceed the Maximum Benefit. After this extension of benefits provision has been exhausted, all benefits cease to exist, and under no circumstances will further payments be made.

Conversion Plans

Are there insurance coverage conversion plans upon my termination from the university?
A conversion plan is available. The conversion plan does not provide the same premium rate and benefits as the Student Health Insurance plans. A conversion plan enrollment form, as well as a description of benefits provided, is available at the Student Health Plans Office at Wardenburg Health Center, room 251) or contact Student Resources at 800-767-0700 and ask for the Customer Service Department. If you purchase a health insurance conversion plan, you are no longer eligible to use Wardenburg Health Center.