What is the CSS Student Accident & Sickness Insurance Program and how does it work?

The CSS Student Health Insurance Program is an insurance plan designed specifically for CSS students. The plan pays benefits for treatment relating to covered diagnosed sicknesses and accidents. A benefit of $50,000 is paid per sickness and accident.

How do I enroll in this Health Insurance Program?

All registered undergraduate students taking twelve or more credit hours will be enrolled in the Student Health Insurance Plan unless they provide proof of comparable coverage by completing the waiver form. All International students are required to enroll in this plan. Graduate students are allowed to enroll in the plan as well. The Student Accounts Office at CSS handles all of the enrollments for the Health Insurance Program.

What is my Deductible?

The CSS Health Insurance Program has a $25 deductible per injury and/or sickness. Generally, this deductible does not have to paid at the time you receive services but instead will be under the "patients responsibility" of your Explanation of Benefits.

How does the program work?

The plan will pay 80% of the PPO allowance up to $50,000 per accident or sickness. If you choose to seek treatment from a non-network provider, then benefits will be paid at 60% of ususal and reasonable expenses.

Can I go to the Emergency Room?

Yes, you may receive benefits for the emergency room. However, there must be a diagnosed sickness or accident and it must be considered an emergency (life-threatening).

Are benefits for psychotherapy available?

Yes. The CSS Health Insurance Program provides 80% benefit for the first ten hours of outpatient treatment and if the insured requires additional outpatient treatment, the Insurance Company will allow up to 75% of the cost of the next 30 hours of treatment. If an insured requires hospital confinement for a mental or nervous condition, the plan will pay the same as any other sickness up to a maximum of 30 days per sickness.

Does my plan cover prescription drugs?

The plan provides a $200 policy year benefit per sickness or accident for prescription drugs. The insured pays for the prescription and then after filing a claim, submits a paid receipt for the prescription and is reimbursed at 80% of the cost of the prescription.

Is there a Preferred Provider Network that I must utilize?

The CSS plan utilizes Preferred One as its PPO Provider Network. When you receive treatment from providers within this network, covered benefits will be paid at 80%. If you choose to receive benefits from a non-network provider, covered benefits will be payable at 60% of usual and reasonable expenses. A listing of Preferred One providers is available at 1-800-451-9597 or you may visit their website: http://preferredone.com.

I am planning on studying abroad while I am at St. Scholastica, will this insurance plan cover me?

Yes, this Plan provides worldwide coverage.

Are pre-existing conditions covered in this Plan?

Yes, with the following rules: The pre-existing condition must be an eligible benefit to the Plan. In order to receive benefits you must provide a certificate of credible coverage from your current insurance company and attach this to your first claim form that you file. The certificate of credible coverage must be from a group insurance plan. Other student plans and individual plans do not constitute comparable coverage.

How do I file a claim?

Download a claim form at:
www.visit-aci.com/forms/COM-07.pdf. Complete the claim form and submit it to Administrative Concepts, Inc., 997 Old Eagle School Road, Ste. 215, Wayne, PA 19087-1706.

How much does my insurance cost:

The insurance premium for the 2007-08 policy year is $1030 annually. The plan begins on September 2, 2007 and terminates on September 2, 2008.

The Student Center for Health and Well-Being is a part of the
Student Affairs Office.