Selection/Reporting Form Due Dates for 2011-2012
June 22 for students attending Fall semester (QSHIP coverage August 15, 2013 through August 14, 2014).
December 1 for Spring 2014 midyear admissions and add-ons (QSHIP Coverage starts Jan 1, 2014-August 14, 2014).
June 1st for Summer 2014 (QSHIP Coverage June 1,2014-August 14, 2014).
The state of Massachusetts and Brandeis University require that full- and three-quarter-time students have health insurance that meets the state regulations (search student health insurance). The intention of the law is to ensure that students have access to routine and emergent medical services in the area they are attending school.
The state further requires that students report their insurance coverage to the University each year. You may do this through SAGE or by downloading the appropriate insurance selection and reporting form and mailing the completed form to the Health Center.
The State requires all schools to offer a qualifying student health insurance plan(QSHIP) to their 3/4 and full time students. You may purchase and enroll in the Brandeis QSHIP or you may report your own comparable insurance (you may use your parents plan until your 26th birthday). Failure to report your comparable insurance or select the Brandeis QSHIP will result in a charge for the QSHIP on your bill and may result in a delay in the receipt of your insurance information.
Undergraduate students have unlimited access to Brandeis Health Center through the mandatory fee. Graduate students must purchase access by selecting the health service fee when reporting and selecting their insurance. This fee is in addition to the student health insurance requirements and provides optional unlimited access to the on campus health center and 12 visits at the Psychological Counseling Center.
Alternate Comparable Insurance Provider
You may waive coverage with the QSHIP if you are reporting alternate comparable insurance. It is your responsibility call your insurance agent to assure that your plan meets the following requirements. It may be necessary for you to purchase additional coverage or to select the QSHIP provided through Brandeis.
Comparable coverage means:
- The policy must be purchased through a U.S. based carrier company or U.S. based subsidiary. Foreign insurance plans (including Embassy-sponsored plans) cannot be reported per MA regulations.
- Plans must provide comprehensive coverage including preventive and primary care services, ambulatory services, emergency services, and hospitalization benefits. These services must be accessible to the student in the area where the student attends school.
- Out of state Medicaid programs and MA limited plans such as Mass Health Limited, Essential or Basic, Health Safety Net, or Commonwealth Care (>19 yoa) plans cannot be reported per MA regulations.
- The annual policy must have a minimum of $500,000 coverage.
- Mental health and substance abuse must be covered as any other illness or injury. This means that both in-patient and out-patient treatment must be covered.
- Injuries or illnesses that occur as a result of alcohol, illegal drugs or self harm must be covered as any other illness or injury.
- Pregnancy and STI screening and treatment must be covered according to USPSTF guidelines.
- There must be coverage for pre-existing conditions.
- Prescription drug coverage must be subsidized with coverage in MA.
- Emergency medical transportation if you become ill or injured while away from home or campus must be subsidized.
- Please review your network status, deductibles, coinsurance, and copay expenses against the cost of QSHIP.
The State requires that any student who does not report comparable coverage *must* participate in the insurance program provided by their institution (QSHIP).
If you have financial barriers to purchasing the necessary health insurance please contact Student Financial Services. Please contact Brandeis Health Center's Insurance Coordinator with further questions or concerns at:
1 (781) 736-3681.
Selecting and Reporting Your Insurance to Brandeis
All undergraduate students are encouraged to select or report insurance coverage online in the Sage self-service system. If you report your information on Sage, you do not need to complete the Health Insurance Selection/Reporting Form through this website. Please make a photocopy of the front and back of your insurance card, and send it to the Health Center.
If you are unable to access Sage, print and complete the appropriate Health Insurance Selection/Reporting Form to select QSHIP or report your alternate, comparable insurance information. We prefer that you mail us the completed form, as it is usually easier to read than a fax. Please print clearly.
Please mail the form to:
Brandeis University Health Center
415 South Street, MS 034
Waltham, MA 02454-9110
If you prefer to fax the information, please print clearly. Our fax number is (781) 736-3675.