International Student Health Insurance
UPPS No. 07.09.04
Issue No. 4
Effective Date: 4/10/2013
Next Review Date: 4/01/2017 (E4Y)
Sr. Reviewer: Director, Student Health Center
The purpose of this UPPS is to establish a policy that requires all registered Texas State University international students on non-immigrant visas to secure health insurance coverage that meets the requirements of the Affordable Care Act as a condition of enrollment.
Texas State international students are required to obtain coverage under the designated international student health insurance policy or present acceptable proof of other comparable and adequate health insurance coverage to the Student Health Center. International students must maintain continuous health insurance coverage from the time of enrollment to the time of completion of their degree program at Texas State or until transfer to another institution of higher education.
Texas State international students must maintain continuous health insurance coverage during periods when they have temporarily withdrawn from the university or are not enrolled in classes, but are involved in academic activities such as resolving “incompletes” or participating in required internships or practical training prior to completion of studies. International students that temporarily withdraw from the university or are not enrolled in classes should contact the International Office. The International Office will subsequently contact the Student Health Center for assistance. It is strongly recommended that international students who remain in the U.S. in a non-immigrant status after completion of their studies at Texas State maintain continuous health insurance coverage, including medical evacuation and repatriation coverage.
INTERNATIONAL STUDENTS AFFECTED BY INSURANCE REQUIREMENT
The International Office determines which visa categories are required to obtain insurance. The visa code will cause the medical insurance fee to be charged on the student’s registration bill.
All international students on non-immigrant visas are subject to the mandatory health insurance requirement.
International students living in the United States under a visa permitting permanent residence or international students who are permitted by Congress to adopt the United States as their domicile while they are in this country are exempt from the mandatory health insurance requirement. A listing of categories of international students eligible to establish domicile in the United States may be found at the U.S. Citizenship and Immigration Services website.
J-1 visa students are required by federal regulation to have insurance for their spouse and dependents which meets the criteria specified in Section 04.01 of this policy statement. Insurance coverage for spouses and dependents of international students with other visas is available.
International students who are also employees of Texas State and covered by employee insurance must purchase an insurance rider which provides a minimum coverage of $7,500 for repatriation of remains and $10,000 for expenses associated with medical evacuation to the student’s home country. Students must be covered by their health insurance plan at the beginning of the semester in order to request a health insurance waiver.
NOTICE OF INSURANCE REQUIREMENT
The Office of Undergraduate Admissions and the Graduate College will notify prospective international students of this insurance requirement upon acceptance and in appropriate university publications and websites. These offices are responsible for entering the appropriate visa code into the student record file at the point of application. The International Office shall provide further information about health insurance at orientation programs.
The International Office will monitor J-1 students to ensure their spouses or dependents, classified as J-2 visa holders, who reside or will reside in the U.S., have adequate insurance to meet the requirements established in Section 04.01.
INTERNATIONAL STUDENT INSURANCE WHEN ATTENDING TEXAS STATE FOR MORE THAN ONE SEMESTER
The Student Health Center, either independently or in conjunction with The Texas State University System, will obtain a health insurance plan that is competitively priced and meets the health insurance coverage requirements mandated by the Affordable Care Act for student health plans. The health insurance plan must provide “essential health benefits” which include:
Ambulatory patient services;
Maternity and newborn care;
Mental health and substance use disorder services, including behavioral health treatment;
Rehabilitative and habilitative services and devices;
Preventive and wellness services and chronic disease management; and
Pediatric services, including oral and vision.
Insurance coverage must also include repatriation of remains in the amount of at least $7,500, and medical evacuation to the student’s home country in the amount of at least $10,000. The deductible amount is not to exceed $500 per policy year.
INTERNATIONAL STUDENT INSURANCE WHEN ATTENDING TEXAS STATE FOR ONE SEMESTER OR LESS
International students may purchase a short-term limited duration health insurance policy as allowed in the Affordable Care Act. A short-term limited duration health insurance policy is defined as a non-renewable individual health benefit plan with a policy period of not more than six months. While short-term limited duration health plans do not have to comply with the full requirements of the Affordable Care Act, the following benefits are required by Texas State:
Minimum medical benefits coverage of $100,000;
Repatriation of remains coverage of at least $7,500;
Medical evacuation to student’s home country of at least $10,000; and
Deductible not to exceed $500 during the policy period.
REQUESTING A HEALTH INSURANCE WAIVER
- International students required by this policy to have health insurance as a condition of enrollment may apply for an online insurance waiver at the Student Health Center each semester if they can provide proof of coverage with an insurance plan providing at least the minimum coverage specified in Sections 04.01 and 05.01. The amounts of coverage must appear in U.S. dollars on the proof of coverage provided. The insurance must be underwritten by an insurer with an established record of claims payment in the United States. The Student Health Center will make the determination as to the acceptability of the insurance plan. International students seeking to obtain an insurance waiver should provide the appropriate documentation to the Student Health Center prior to completing payment of tuition and fees or prior to the due date shown on the registration bill, whichever comes first. International students who are attending Texas State for more than one semester will be required to show proof of coverage that provides “essential health benefits” as required by the Affordable Care Act. Students who are attending for one semester or less may provide proof of coverage in the form of a “short term limited duration” policy and must submit their waiver request through their academic program.
PAYMENT OF INTERNATIONAL STUDENT Health INSURANCE PREMIUMS
In the absence of a valid insurance waiver (see Section 06.01), the insurance premium required to obtain insurance coverage for a semester will be assessed as part of the international student’s registration bill for that semester. International students enrolling for a spring semester will be required to pay for health insurance coverage through both the spring and summer semesters to ensure continuous coverage. International students enrolling for a summer session will be required to pay for health insurance coverage through the end of the summer semester to ensure continuous coverage. The insurance premium is not deferrable, and must be paid in full, together with other non-deferrable fees, according to the payment instructions provided by Student Business Services. To avoid the cancellation of classes or delinquent payment penalties, international students required to have health insurance must either obtain a valid insurance waiver prior to completing payment of tuition and fees or must pay the minimum amount due by the due date shown on the registration bill.
International students who want to obtain insurance coverage for a spouse and dependents may contact the Student Health Center for assistance in obtaining this additional coverage.
J-1 visa students are required by federal regulation to obtain insurance coverage for their spouse and dependents. J-1 visa students must obtain a valid insurance waiver and provide proof of insurance coverage for their spouse and dependents to the International Office by the due date shown on the registration bill.
International students who decide to purchase the annual policy from the designated student health insurance company at the time they register for the fall semester will have to provide proof of such purchase in order to be exempt from having to request an insurance waiver each semester. The Student Health Center will process override codes to prevent insurance premiums from being assessed.
Graduating international students eligible to remain in the United States as determined by the International Office and applicable federal law may apply to extend their health insurance coverage. International students interested in a continuation plan should contact the insurance provider or the Student Health Center for eligibility and premium information.
The Student Health Center will reconcile the insurance collections each semester prior to requesting the payment for the insurance company.
Student Business Services will be responsible for investigating any discrepancies in the billing and collection process. The General Accounting Office will process requests for payment to the insurance company.
The Student Health Center will notify Student Business Services no later than April 1 of the student health insurance premiums for the following fiscal year.
INSURANCE PREMIUM REFUNDS
International students who provide proof of comparable insurance to the Student Health Center, as required in Sections 04 and 05, within the first twelve class days of the semester may obtain an insurance premium refund. The Student Health Center will assist in obtaining the refund from the insurance company.
International students who withdraw from the university may be eligible for a refund of a portion of their insurance premium. Students must contact the health insurance company for assistance in obtaining a refund.
EMERGENCY TUITION LOAN PROGRAM
- Emergency Tuition Loan Program funds may not be used for the payment of international student health insurance premiums.
REVIEWERS OF THIS UPPS
Reviewers of this UPPS include the following:
Position Date Director, Student Health Center April 1 E4Y Director, International Office April 1 E4Y Director, Undergraduate Admissions April 1 E4Y Dean, Graduate College April 1 E4Y Director, General Accounting April 1 E4Y Director, Student Business Services April 1 E4Y
This UPPS has been approved by the following individuals in their official capacities and represents Texas State policy and procedure from the date of this document until superseded.
Director of Student Health Center; senior reviewer of this UPPS
Assistant Vice President for Student Affairs and Director of Counseling Center
Vice President for Student Affairs