University of Colorado at BoulderStudent Health Plans
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Plan year: August 18, 2008–August 17, 2009

Student Gold Health Insurance Plan

Costs and Coverage Dates

Fall semester 2008

Fall semester coverage dates
August 18, 2008–January 4, 2009

Fall semester cost (billed fall semester)
Student - $860
Spouse/domestic partner - $2,136
Per child - $1,124

Optional Supplemental Plan

Fall semester enrollment deadline:
September 3, 2008

Spring semester/summer 2009

Spring semester/summer coverage dates
January 5–August 17, 2009

Spring/summer cost (billed spring semester)
Student - $860
Spouse/domestic partner - $2,136
Per child - $1,124

Optional Supplemental Plan

Spring semester enrollment deadline:
January 21, 2009

Summer only 2009

Summer coverage dates
June 1–August 17, 2009

Summer only cost
Student - $430
Spouse/domestic partner - $1,080
Per child - $562

Optional Supplemental Plan

Summer enrollment deadline:
June 8, 2009

For exceptions, go to Exceptions to Automatic Enrollment

Premiums paid for both fall and spring semester/summer provide a full year of coverage. (Spring semester cost includes summer coverage, but does not include the Wardenburg Health Center summer user fee.)

For summer-only coverage, students must enroll and pay at the Student Health Plans Office, located in Wardenburg Health Center, room 336.

Optional Supplemental Plan

$750,000 Maximum Lifetime Benefit

This optional benefit is subject to payment of an additional premium of $140 per year. Optional benefits may only be purchased at the time of initial enrollment in the Plan and may not be added later. The Optional Supplemental Benefit begins payment after the Basic Maximum Benefit of $250,000 has been paid by the Company. The Company will pay 100% for additional, incurred Covered Medical Expenses up to the Supplemental Plan Maximum of $750,000. The total benefit payable under Supplemental Plan is $1,000,000 minus the Basic Benefits already paid. The Supplemental Plan option will cover 100% of covered medical expenses in or out of network. For enrollment or more information go to www.aetnastudenthealth.com.

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