Insurance Plan Waiver Requirements
If you have active health insurance with benefits that meet all the criteria listed below, you may apply for waiver of enrollment in the WesternU plan. You will need to have your current insurance ID card and information regarding your plan benefits to complete the process. A copy of the front and back of your Health Insurance ID card must be submitted with your request. Once you have submitted the required information, you will receive an email verifying if your waiver meets the WesternU requirements. Waivers will not be accepted past the required deadline.
All full-time students MUST be covered by an ACA compliant domestic health insurance plan for the entire academic year, including summer and holidays.
The acceptable coverage to waive the WesternU – Sponsored Student Health Insurance Plan is a parent’s employer group plan, a spouse’s employer group plan, a student’s own employer group plan, VA Benefits or COBRA. Individual Plans will be accepted for the 2023-2024 Policy year as long as they meet the University’s waiver requirements. Additionally, the University will allow students to waive out of the student health insurance plan using Medicaid based coverage that originates in the state of California (Pomona campus students) or the state of Oregon (Lebanon campus students). The University will not approve any other state’s Medicaid coverage as an acceptable waiver, subject to the Distance Education Program exception below. Please note: To be eligible to waive with COBRA coverage you must provide proof of payment on a monthly basis to the office of HSAC.
Students participating in distance education programs such as those offered by the College of Graduate Nursing program may waive out of the student health insurance plan using Medicaid based coverage that originates in the state in which they currently reside.
In order to waive out of the student health insurance plan, your deductible MUST NOT be more than $1,000 individual annually, NO exceptions. Your plan must provide adequate major medical coverage of at least $1,000,000/policy year, that includes prescription and mental health coverage as well as coverage for an annual exam. In addition, your plan must utilize a provider network in the area of the campus you are attending for primary care, specialty, hospital, and diagnostic care. Students attending online programs, including those that are only partially online are exempt from the provider network requirement.
California or Oregon based students who waive out of the student health insurance plan using their respective state’s Medicaid based coverage may only be eligible for coverage of emergency services while completing clinical rotations/experiences out-of-state. Some of the University’s out-of-state clinical rotation/experience sites may require that you have comprehensive health insurance coverage; therefore, you may not be eligible to attend certain clinical rotation/experiences using Medicaid based coverage. Students using Medicaid based coverage while completing a clinical rotation/experience out-of-state are responsible for all medical expenses incurred that are not covered by their Medicaid based plan. Graduating students completing clinical rotations/experiences out-of-state that match to an out-of-state residency program during their final year should note that their out-of-state placement may cause them to lose eligibility for their respective state’s Medicaid based coverage.
Short-term health insurance policies, traveler’s plans, or plans originating outside of the United States will not be accepted as part of the Waiver process.
If an acceptable waiver is not received by the posted waiver deadline, your enrollment in the student health insurance plan will be finalized, you will no longer be eligible for a refund of the fall 2023 premium, and your student account will automatically be assessed the applicable spring 2024 premium during registration.
Health insurance plans approved during the waiver process will be verified periodically to ensure students remain in compliance with the University’s health insurance coverage requirements.
To ensure that health insurance coverage requirements are met, all full-time students are automatically assessed for half of the annual student health insurance premium upon registration for fall. This fee is reversed only if you submit proof of health insurance coverage that meets the University’s coverage requirements. When you fail to submit proof of alternative health insurance coverage by the deadline for your program/class year, your enrollment in the student health insurance plan is finalized. In addition, you are no longer eligible for a refund of the first half of the premium and you will automatically be assessed the second half of the premium upon registration for the spring term.
If your waiver is denied, you may appeal the decision. The University will only override the waiver denial if you meet one or more of the following criteria: (1) As the student you are enrolled on a parent, guardian or spouse’s health insurance plan and the responsible party signs the High Deductible Appeal Form on your behalf. (2) You can provide documentation (current statement) of a health savings account that holds a balance that will cover the difference between your health insurance plan deductible and the University’s $1,000.00 deductible requirement. Instructions and deadlines for submitting your waiver appeal will be provided in your waiver denial e-mail.
If your waiver is approved, it is still subject to periodic verification throughout the academic year to ensure the plan you submitted is still active and still meets the University’s health insurance coverage requirements. It is incumbent on the student to ensure their plan remains active and in compliance with the University’s health insurance requirements throughout the current academic year, including summer and holidays. If your plan is found to be inactive or out of compliance, the University reserves the right to enroll a student in the student health insurance plan from the start of the period of non-compliance (even if your termination date was in the past) through the end of the current academic year. If your plan is found out of compliance, you will receive an e-mail notification from HSAC and you will have 14 calendar days to respond. If you have not responded within 14 calendar days, the University will proceed with enrollment in the student health insurance plan, assess your student account the applicable premium charges, and notify your program of your non-compliance with the University’s health insurance requirements.