Health Insurance Requirements
Health Insurance Requirements:
Important Note: These requirements are required by the Kansas Board of Regents who oversee all Kansas Universities. Emporia State University did not create this list, but we must follow it. We will not make exceptions or overlook requirements. Your insurance must meet ALL of the following requirements or it will not be considered as a suitable replacement for the school insurance plan.
A. Coverage for Essential Benefits (with no dollar limits) as defined under the Patient Protection and Affordable Care Act (ACA). Stand-alone travel and/or emergency/urgent care coverage is not acceptable. The policy must include:
- Pharmacy
- Mental health services
- Maternity benefits
- Preventative care
- Coverage for pre-existing conditions
- Pediatric dental and vision coverage (if you have dependent children on the plan)
B. Unlimited Maximum Benefit for covered medical expenses
C. A policy year deductible of $500 or less
D. Maximum total out-of-pocket expenses cannot exceed $8,200 per member ($16,400 per family) with preferred providers (deductibles, coinsurance, and copays all count toward the out-of-pocket maximum)
E. A minimum of 75% coinsurance payable by the insurance plan to network providers
F. Coverage includes effective dates spanning the entire period for which the waiver is requested:
- Fall Semester: 08/01/2020 through 12/31/2021
- Spring Semester: 01/01/2021 through 05/31/2021
G. Plan documents are written in English, with currency amounts converted to U.S. dollars, and the insurance company contact phone number is located in the U.S.
H. Insurer has a base of operations in the U.S. or has a U.S. based claims payer
I. Insurer is authorized to do business in Kansas and is providing coverage under a policy that has been filed and approved by the Kansas Department of Insurance
J. At least $100,000 in coverage for repatriation and medical evacuation benefits
K. Travel policies, Short Term Limited Duration Policies (STLD), Disability Policies, Hospital Indemnity Policies, Accident Only Policies, Emergecny/Urgent Care Only Policies and other limited benefit policies are not acceptable
Travel Insurance is not the same as Health Insurance. A Travel Insurance policy will not meet the requirements for student health insurance because Travel Insurance does not provide the same coverage and the same benefits. The state of Kansas does not recognize Travel Insurance as a suitable replacement for Health Insurance. This policy is intended to make certain that students will have adequate coverage during their stay in the United States.
L. Coverage is provided by an employer’s group plan compliant with items A-J or is backed by the full faith and credit of the student’s home government (Examples: Saudi Arabia, Kuwait, etc.)