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Table of Contents
Getting Started .............................................................................................................................................................. 2
Where can I learn about the student health insurance plan (SHIP)? ......................................................................... 2
Enrolling in My SHIP ..................................................................................................................................................... 2
Am I eligible for student health insurance? ................................................................................................................. 2
How do I login to enroll or waive (opt out) of SHIP? ................................................................................................... 2
How do I enroll my dependents? ................................................................................................................................ 2
Can I enroll my dependents outside of the open enrollment period? ......................................................................... 3
Am I eligible to waive? ................................................................................................................................................ 3
How do I waive health insurance coverage? .............................................................................................................. 3
Will you audit or verify my waiver request? ................................................................................................................ 4
Can I cancel my waiver form after I’ve submitted it? .................................................................................................. 4
If I waive, but then lose my coverage, can I enroll in SHIP or enroll my dependents if they lose coverage? ........... 4
Once enrolled, can I cancel? Get a refund? ............................................................................................................... 5
About My Benefits ......................................................................................................................................................... 5
Have changes been made to this year’s plan? ........................................................................................................... 5
Do I need a referral from my school's Health Services to see an off-campus health provider? ................................. 5
Am I still covered if I live off campus? While traveling? When studying abroad?....................................................... 6
Am I still covered after I graduate? ............................................................................................................................. 6
What other services are available to me through my SHIP? ...................................................................................... 6
What other insurance products are available to students? ......................................................................................... 7
How do I obtain a tax form? ........................................................................................................................................ 7
Contact Information ...................................................................................................................................................... 8
Who do I contact? ....................................................................................................................................................... 8
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Getting Started
Where can I learn about the student health insurance plan (SHIP)?
Go to
Enrolling in My SHIP
Am I eligible for student health insurance?
All domestic undergraduate students who pay registration fees and are matriculating toward a degree through
Claremont McKenna College are eligible. All international undergraduate students (this includes non-student
exchange visitors such as visiting faculty, scholars, and researchers) with a current passport or student visa (F-1, J-
1, or M-1 visa) temporarily located outside the home country who have not been granted permanent residency status
while engaged in full-time educational activities through Pitzer College are automatically enrolled. Once you meet
eligibility for the first 31 days from the effective date of your Plan, you are enrolled for the remainder of the coverage
period. Home-study, correspondence and online courses do not fulfill this requirement.
How do I login to enroll or waive (opt out) of SHIP?
1. Go to www.gallagherstudent.com/cuc.Pitzer .
2. Follow the login instructions.
3. View “Account Details” found on the lower left side of landing page.
How do I enroll my dependents?
1. Go to www.gallagherstudent.com/cuc.Pitzer.
2. Follow the login instructions.
3. Click “Enroll”.
4. Follow the instructions to complete the form to enter and enroll your “Dependent Spouse/Partner” and/or
“Dependent Children”.
You must purchase dependent insurance for the same coverage period as your own coverage; it can’t be for a
longer or shorter period than your own. For example, if you enroll for fall coverage, your dependents need to be
enrolled for fall coverage; you wouldn’t be able to enroll them for annual coverage. If you enroll for fall coverage
and do not enroll your dependents at that time, you cannot enroll your dependents unless a qualifying event
occurs.
NOTE: If enrolling a dependent for the first time in SHIP, documentation needs to be uploaded at the time of
submission. For example a marriage certificate for Dependent Spouse or Birth Certificate for Dependent Child.
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Can I enroll my dependents outside of the open enrollment period?
You can only add eligible dependent(s) outside of the enrollment period if one of these qualifying events occurs:
• You get married
• You have a child
• You get divorced
• Your dependent enters the country for the first time
• Your dependent loses coverage under another insurance plan
In such cases, you must submit a Dependent Petition to Add form with supporting documentation and payment to
Gallagher Student Health & Special Risk within 31 days of the qualifying event. The form can be found on your
school’s page at www.gallagherstudent.com/cuc.Pitzer. If approved, coverage for your dependents will start on the
date of the qualifying event. Your premium will be pro-rated. Requests received after 31 days will not be processed.
Note: Once your dependent is enrolled, you can’t terminate dependent coverage unless you lose your Student Health
Insurance eligibility.
Am I eligible to waive?
To be eligible to waive your SHIP, you must be currently enrolled in a health insurance plan that meets your school's
waiver requirements.
Waiver requirements include being enrolled in a health insurance plan that is fully compliant with all provisions of the
Affordable Care Act (ACA), requires you to have access to providers near campus and coverage for services beyond
urgent and emergency services. Therefore, if you are enrolled in an out-of-state HMO, your coverage will likely be
limited — or unavailable — outside of your HMO’s service area and will not meet your school's waiver requirements.
If a claim is submitted before you have an approved waiver, you must stay enrolled in the plan.
How do I waive health insurance coverage?
1. Go to www.gallagherstudent.com/cuc.Pitzer.
2. Follow the login instructions.
3. Click on the “Waive” button under “Plan Summary.”
4. You will need your health insurance information.
5. Follow the instructions to complete the form.
6. A reference number will be emailed upon submission; however, final determination may take 24–48 hours.
Note: Your insurance information is required to complete the waiver form; you do not need to upload documents
at the time of initial submission. You will receive an email notification if additional documents
are needed.
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Will you audit or verify my waiver request?
Yes, we will audit or verify your waiver request. This is to make sure your insurance plan will cover you when you are
at school. Here is how our waiver review process works:
• We check the insurance company information you entered on your form to make sure it’s accurate and that
your coverage is active.
• We verify most waiver requests within 1-2 business days.
• Once we verify your coverage, we’ll email you at the address you provided on your form to let you know if
your waiver request was approved or denied. If we deny your request, we’ll tell you why. We’ll also guide you
should you wish to revise and resubmit your form and supporting documentation.
Can I cancel my waiver form after I’ve submitted it?
Yes, if it's before your waiver/enrollment deadline of 9/13/2023
1. Go to www.gallagherstudent.com/cuc.Pitzer.
2. Follow the login instructions.
3. Navigate to “Account Details”.
4. Click “Edit Waiver”.
5. Select the form you want to edit.
6. Update the form as needed.
7. Click “Update & Submit”.
NOTE: You can edit your waiver up to 5 times.
You may not edit your form after 9/13/2023.
If I waive, but then lose my coverage, can I enroll in SHIP or enroll my dependents
if they lose coverage?
If you waive SHIP and then lose coverage, you can enroll in the plan. Losing coverage is categorized as a Qualifying
Life Event. Other Qualifying Life Events include:
• Reaching the age limit of another health insurance plan.
• Involuntary loss of coverage from another health insurance plan.
You can only add eligible dependent(s) outside of the enrollment period if one of these qualifying
events occurs:
• You get married
• You have a child
• You get divorced
• Your dependent enters the country for the first time
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• Your dependent loses coverage under another insurance plan
To initiate the Qualifying Life Event process:
1. Go to www.gallagherstudent.com/cuc.Pitzer.
2. Follow the login instructions.
3. Click on “Enroll-Qualifying Life Event.”
4. Complete the online form and upload the required supporting document, such as the loss of coverage letter
from your prior health insurance company showing your name and the last day of coverage.
Note: Read the form carefully as it contains very specific information on the Qualifying Life Event process.
Once enrolled, can I cancel? Get a refund?
Once you are enrolled in SHIP, you will remain enrolled in the plan for the full coverage period. You have no option to
terminate coverage unless you enter the armed forces. In that case we will refund — or your student account will be
credited — a pro-rated share of your premium. If you are an international student withdrawing or graduating from
your school and returning to your home country, you may qualify for a pro-rated refund of premium. Note: If there
are any claims submitted and paid by the carrier the plan may not be terminated.
About My Benefits
How do I find out more about my benefits?
Plan benefit information and costs are available here: My School | Aetna Student Health
Have changes been made to this year’s plan?
No changes were made to the plan for the 2023–2024 Policy Year.
Do I need a referral from my school's Health Services to see an off-campus health
provider?
Yes, you need a referral before you see an off-campus provider. Without one, your health benefits could be denied or
reduced. To see how referrals works and any exceptions to the referral process, review your SHIP brochure.
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Am I still covered if I live off campus? While traveling? When studying abroad?
Yes, your plan covers you wherever you are. As long as you are enrolled in SHIP and paid the premium, you'll be
covered. Your plan also provides you with 24 hour Worldwide Travel Assistance which includes services ranging
from a lost passport to helping with emergency medical assistance or arranging for emergency medical evacuation or
repatriation of remains. It’s important to contact
Oncall International
(1-866-525-1956) before making arrangements
on your own. Otherwise these services will not be covered
.
Other information about seeking medical care abroad:
• Always keep your SHIP ID card with you.
• Save a copy of the plan brochure and/or bookmark your student health website.
• If you get sick while abroad, you will likely need to pay for your care first and then submit bills for
reimbursement. Your covered expenses will likely be considered an out-of-network expense.
• Before you submit claims for reimbursement, have the itemized bill(s) translated into English.
Also include a letter informing the claims administrator you already paid for the healthcare service
and need to be reimbursed.
• Write your name, ID number, address and school name on your bill(s). This will help the claims
company process your reimbursement request correctly and promptly.
Am I still covered after I graduate?
You will be covered under your SHIP until the end of the policy period for which you are enrolled in SHIP and have
paid your premium. If you enrolled and paid for the fall semester and graduate in December, you will be covered until
the end of the fall semester coverage period. If you enrolled and paid for annual or spring/summer coverage and
graduate in the spring, you will be covered until the end of the policy year. You won’t be able to continue your
coverage after your policy terminates.
What other services are available to me through my SHIP?
The following services are included and complement your SHIP program:
• SilverCloud Health — is the leading digital mental Digital Mental Health Platform health company, enabling
colleges and universities to increase the reach of campus counseling services without increasing staff.
SilverCloud programs enable students to access care on their own time in a relatable and accessible format
.
• Student Dental Savings — this is a discount program —not insurance— that will help make dental care
more affordable. Students save 10% to 50% on dental care expenses at any participating UNI-CARE dental
provider nationwide. Please note there is a voluntary dental program (described on the page below –
enrollment is direct through the carrier not through the school)
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• Student Vision Savings — this is a discount program —not insurance— that will help make vision care
more affordable. Students save 10% to 60% off eyeglasses, contact lenses and other retail eyewear items,
as well as 10% to 30% off eye examinations at any participating Coast to Coast Vision™ provider and 40%
to 50% off the national average on LASIK.
For more information on the complements programs please visit www.gallagherstudent.com/cuc.Pitzer.
What other insurance products are available to students?
The following services are also available to students:
• Personal property and Renters Insurance are available to all students on a voluntary basis and covers
you while on- or off-campus, at home, or abroad. All of your belongings including cell phones, laptops,
clothing, books and much more are protected from accidental damage, theft, fire damage and water damage.
For details, go to www.gallagherstudent.com/property to get a quote and enroll. Please visit
www.gallagherstudent.com for complete details about additional insurance products and how to enroll.
• Dental or Vision Insurance Plans are available to all students to purchase on a voluntary basis at an
additional cost. Go to www.gallagherstudent.com/dental or www.gallagherstudent.com/vision.The types of
plans and availability of plans vary by state. All students are eligible to enroll, you do not have to be enrolled
in SHIP.
• Tuition Refund Insurance is available to you on a voluntary basis at additional cost and can protect up to
100% of your education investment should a student need to withdraw for illness, injury, mental health
disorder or an unexpected circumstance. Please visit www.gallagherstudent.com for complete details about
additional insurance products and how to enroll.
How do I obtain a tax form?
If the federal government requires reporting of health insurance coverage for 2023, tax forms will be mailed to the
address on file by either the Insurance Carrier or the Claims Administrator. Please refer to the Important Contact
Information Section of this document for further information.
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Contact Information
Who do I contact?
See the guide below:
Answer Needed Who To Contact Contact Information
Enrollment, Coverage or
Service Concerns
Gallagher Student Health &
Special Risk
500 Victory Road
Quincy, MA 02171
www.gallagherstudent.com/cuc.Pitzer
click “Help Center” or call 833-882-3588
ID Cards, Benefits, Claims,
Claims Payments Incurred and
Tax Forms On or After
8/1/2023
Aetna Student Health
Aetna Student Health PO Box 981106 El Paso, TX 79998
Phone:877-480-4161 Website:
www.aetnastudenthealth.com
Preferred Provider Network Aetna EPO Network
Phone: 1-866-618-0028 Website:
www.gallagherstudent.com/cuc.Pitzer
click “Find a Doctor”
Participating pharmacies Aetna Pharmacy Network
Phone: 1-866-618-0028 Website:
www.gallagherstudent.com/cuc.Pitzer
click “Pharmacy Program”
Voluntary Dental
Ameritas Dental Phone: 1-855-672-3232
Gallagher Student Health
Complements
(SHIP Plan Enhancements)
Coast to Coast Vision
(Discount Vision)
Uni-Care (Dental Savings)
SilverCloud (Behavioral
Health)
www.gallagherstudent.com/cuc.Pitzer
click “Program Enhancements”
Worldwide assistance services
(medical evacuation and
repatriation)
On Call Travel Assistance
Toll-free within the United States:
1-866-525-1956
Collect from outside of the United States:
00-1-603-328-1956
Additional Student Assistance
Programs
24/7 Nurseline or Student
Assistance Program
Phone: 877-351-7889
Telehealth services TELADOC
Phone: 855-TELADOC (835-2362)
