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Wisconsin Common Student
Accident and Sickness Insurance Plan
Overview
University of Wisconsin-Green Bay offers a voluntary health insurance plan. For detailed information
about the plan go to http://www.sas-mn.com/
Eligibility
All registered students taking a minimum of 5 credit hours are eligible to enroll in the plan.
Annual Premium Rates - Domestic
- Student $1,177.00
- Student and Spouse/Domestic Partner $4,708.00
- Student and Children $4,120.00
- Student, Spouse/Domesstic Partner and Children $7,652.00
Annual Premium Rates - International
(Office of International Education)
- Student $795
- Student and Spouse/Domestic Partner $4,940
- Student, Spouse/Domestic Partner & Child(ren) $8,040
- Student and Child(ren) $4,025
Semi-Annual, Quarterly and Semester premium payments available. Visa and MasterCard accepted.
Intercollegiate sports coverage and rates, on a voluntary basis, are available and will be provided
on the enrollment application.
For a complete copy of the policy or if you have any questions, please call: Student Assurance Services, inc., toll free 1-800-328-2739.
INSURANCE INFORMATION YOU NEED TO KNOW...
- The insurance can be purchased annually, semi-annually, quarterly or by the semester.
- The insurance does send renewal reminders. However, be aware that they send it to the address you provided initially. It is your responsibility to report address changes to the insurance company. Renewals are ultimately your responsibility
so mark your calendar to prevent a lapse of coverage.
- The insurance is a "preferred provider" policy (see page 6 of brochure) which means there are certain
medical facilities and physicians which will provide you with an 80/20 split on costs of covered
benefits. To locate a preferred provider visit http://www.healtheos.com
- click on providers
- click on find a doctor or hospital
- search for provider by using zip code and 50 mile radius
- If you go to an "Out of Network" (someone not on the Preferred Provider List) the insurance will only
pay a 60/40 split ON THE BENEFITS.
- It is important that you read your insurance booklet, especially those items that are NOT
COVERED (THE EXCLUSIONS AND LIMITATIONS SECTION).
- If you do have reason to file a claim, print a copy of the claim form which is on-line at http://www.sas-mn.com/claimform download.html , make a copy of the material (invoice, etc.) and send the original
in to the insurance company at: Student Assurance Services, P. O. Box 196, Stillwater, MN 55082-0196. Keep a copy
for your records, documenting the date sent in and any other pertinent information.
- YOU MUST RESPOND to any correspondence you receive from the insurance company promptly. Failure to do so
within the required timeframe can result in forfeiture of coverage for that claim.
- A copy of your insurance card is in the insurance packet. Additional insurance cards are available on
line at: http://www.sas-mn.com/ . You must log-in to have access to
a duplicate insurance card.
- The policy number is on the membership card.
SENIORS!!!!! - Now is the time to begin thinking about insurance coverage once you graduate. The current student policy can be extended after graduation. Contact Candy Mears at (651) 209-5991 to write up a policy.
For more information on enrollment application, contact the University of Wisconsin-Green Bay
Counseling and Health Center at (920) 465-2380.
Last updated: 9/18/07
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