Academic Health Center (AHC) Student Health Benefit Plan
A special plan design has been developed for Academic Health Center
Students (Medicine and Pharmacy). Starting fall semester 2005, all AHC
students will be automatically enrolled in the new AHC-Student Health
Benefit Plan (AHC-SHBP). This plan provides easy, affordable coverage
for the unique needs of AHC students. You can have the plan waived if
you are eligible. See details under
Waiving The Plan.
Fill out (by handwriting or typing) a copy of the 2-page form
containing: fax cover sheet and acknowledgement of waiver forms.
Attach the forms with your certificate of credible coverage.
You must prove you have other coverage by producing a certificate
of credible coverage obtained from your managed care organization,
insurance company, or a letter to verify your enrollment from your
current insurance company.
Submit all documentseither:
In-person to the Student Health Benefits Office at Boynton Health
Service, 410 Church Street S. E., Room N323, Minneapolis, MN 55455
orby fax Student Health Benefit Plan Office at 612-626-5183
Note: At this time, Academic Health Center
students will not be able to update insurance information through the
University's web registration system.
The Student Health Benefits Office will contact you with the
decision on your petition within 2 weeks of filing. Specific deadlines to waive for every semester
can be found on the website of the
Office of the
Registrar.
Your waiver
will be valid for two years. Should you lose coverage during the
period you have been waived, you may enroll in the plan within
60 days of losing coverage by providing proof of involuntary
loss of coverage from your insurance company.
*You need Adobe
Reader to view these documents. If you do not have Adobe Reader,
download the reader for free
here.
If you have other questions or concerns about the Student
Health Benefit Plan, please contact:
Student Health Benefit Plan Office Boynton Health
Service
Minneapolis, MN 55455
e-mail:
studins@bhs.umn.edu
Phone: 612-624-0627 or 1-800-232-9017 Fax: 612-626-5183
or 1800-624-9881