Selection/Reporting Form Due Dates for 2011-2012

June 30 for students attending Fall semester (QSHIP coverage  August 15, 2011 through August 14, 2012).

December 1  for Spring 2013 midyear admissions and add-ons (QSHIP Coverage starts Jan 1, 2013-August 14, 2013).

June 1st  for Summer 2013/add-ons (QSHIP Coverage June 1,2012-August 14, 2012).

Insurance

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.

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 with the Psychological Counseling Center. 

Alternate Comparable Insurance Provider

You may waive coverage with the QSHIP if you are reporting alternate comparable insurance. If you are using an insurance plan from another carrier, please call your insurance agent to make sure you have adequate and comparable coverage while in Massachusetts. It is your responsibility to carefully evaluate your insurance plan for adequacy before reporting your coverage is comparable to QSHIP. 

Comparable coverage means:

  1. The policy must be purchased through a U.S. based carrier company or U.S. based subsidiary.  Foreign insurance plans (including Embassy-sponsored plans) are NOT accepted. Plans that do not meet this requirement cannot be waived by the University per MA regulation.
  2. Plans which do not cover routine or follow up care in Massachusetts are not eligible. Plans must include coverage for local out-patient diagnostic and medical services as well as hospital based emergency services regardless of admission outcome. Plans not meeting this requirement cannot be waived by the University per MA regulation.
  3. 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 waived by the University per MA regulations.
  4. The policy must have a minimum of $100,000 coverage per injury or sickness.
  5. 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.
  6. Injuries or illnesses that occur as a result of athletics, alcohol, illegal drugs or as the result of an attempt to commit suicide must be covered as any other illness or injury.
  7. Diagnosis and treatment for at risk evaluation of sexually transmitted disease and Pregnancy must be subsidized.
  8. There must be coverage for pre-existing conditions.
  9. Prescription drug coverage must be subsidized with coverage in MA.
  10. Emergency medical transportation if you become ill or injured while away from home or campus must be subsidized.

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 your financial aid office. 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 must fax the information, please print clearly. Our fax number is (781) 736-3675.