Waiving the SHBP

 

Update 5/30/23: The Student Health Benefit Plan (SHBP) waiver for Fall 2023 will become available in mid-July.

 

The process for waiving the Student Health Benefit Plan (SHBP) differs for U.S.-based students and international students. Please refer to the information that is relevant to you: 

1. Domestic Students
2. International Students
3. FAQ

Waivers and enrollments can take up to 20 business days to process, depending on volume.

 

1. Domestic Students

-or-

  • For students who have submitted a FERPA privacy statement to the University or who are unable to submit the SHBP waiver online, download and print the Alternative Insurance Waiver.

A confirmation email is sent within minutes of successfully completing the waiver request online. Print and save this email as proof of your waiver. If you don’t receive a confirmation email, call Wellfleet customer service, (800) 633-7867, for help. Waivers and enrollments can take 10 to 14 business days to process, depending on volume.

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2. International Students

International students studying in person, remotely or on-line and residing on campus or anywhere in the United States are not automatically eligible to waive the SHBP. However, international students enrolled in an employer- or embassy-based health insurance plan from the United States may be eligible for a waiver. Eligibility is based on federal and state guidelines for the minimum essential coverage needed in accordance with the Affordable Care Act. US-based international students seeking a waiver must complete an individual insurance plan review before the end of the Add/Drop period.

To request a review, mail health plan documentation to:

Patient Services
University Health Services, UMass Amherst
150 Infirmary Way, Amherst, MA 01003

-or-

Email documents to patientservices@uhs.umass.edu. Be sure to include your name and contact information in all emails.

UHS' Student Health Benefits Coordinator will review the health plan documentation and notify applicants of their status via email. If approved, UHS will process a paper waiver allowing removal of SHBP charges from the tuition bill.

 

3. SHBP Waiver FAQs

 

Eligibility

Waiver Submission and Approval

 

Eligibility

Who can waive the SHBP?

  • U.S. students with comparable coverage under another major medical insurance plan can waive the SHBP. 
  • Veterans with benefits that provide access to Veterans' Administration healthcare facilities and those with benefits through the U.S. Family Health Plan, a military coverage, can waive the SHBP.
  • International students studying remotely or on-line outside of the US, or who are enrolled in an employer- or embassy-based health insurance plan from the US (see below for more information).

What plans cannot be used to waive the SHBP?

Per Massachusetts General Law 956 CMR 8.00: Student Health Insurance Program, students living outside of their insurance coverage area may not waive participation in the Student Health Insurance Plan. https://www.mass.gov/doc/956-cmr-8-student-health-insurance-program/download

  • Closed network plans, which provide coverage through a closed network of providers not reasonably accessible in the area where the student attends school, are not eligible for SHBP waiver.
  • Out-of-state Medicaid plans cannot be used to waive the SHBP.
  • International plans cannot be used to waive the SHBP, except for students studying remotely in their home countries.

Can I enroll in the SHBP in the spring if I waived it in the fall?

  • Yes. Students who need to enroll in the SHBP after waiving in the fall should contact Patient Services at 413-577-5192. Should your current situation change, such as losing your private health insurance or your enrollment status changes from studying remotely/online to studying on campus, then UHS will work with students to be sure they have comparable insurance coverage.

How do I know if my health insurance plan is comparable coverage to the SHBP?

Coverage Guidelines:

  • Must be a United States-based employer health plan, with claims paid in the United States; or embassy/fellowship sponsored student.
  • Cannot be travel insurance.
  • Coverage must be in force for the full time period in which the student is at UMass Amherst.
  • Student coverage cannot be a closed network of providers that would prevent reasonable access to medical services in the area, except in the event of an emergency.
  • No pre-existing condition clause.
  • Annual plan maximum: $500,000.
  • Ambulatory patient services.
  • Emergency services.
  • Hospitalization.
  • Maternity and newborn care.
  • Mental health and substance use disorder services, including behavioral health treatment.
  • Prescription drugs.
  • Rehabilitative and habilitative services and devices.
  • Laboratory services.
  • Preventive and wellness services, and chronic disease management.
  • Pediatric services.

Waiver Submission and Approval

How do I know if my waiver request was received?

  • A confirmation email is sent within minutes of successfully completing the waiver request. Print and save this email as proof of your waiver. If you don’t receive a confirmation email, call Wellfleet customer service, (800) 633-7867, for help.

How long will it take for my waiver to be approved?

  • Approval by Wellfleet can take up to three business days, and it can take up to 14 additional business days for UHS and the bursar's office to complete the process.

What if my waiver request is rejected?

  • Audits are performed; students whose waivers are rejected during an audit will have an opportunity to correct the information submitted. Waivers not accepted by the university will be recharged to the tuition bill.

Do I have to submit the waiver again in the spring?

  • Waivers submitted during the fall semester apply to the entire academic year. Only new or transfer students need to submit the online waiver request for the spring semester.

I have more questions, whom do I contact?

  • Contact UHS Patient Services: 413-577-5192; patientservices@uhs.umass.edu