University of Hartford

International Student Health Insurance Requirements




Table of Contents

  • Introduction

  • Insurance program cost and payment schedule

  • Insurance coverage highlights

  • Dependent coverage

  • Additional optional coverage - Dental and Vision care

  • Requesting a insurance "Waiver"

  • Who to contact

  • Medical Claim Form

  • How to get a copy of your insurance Card



The University of Hartford requires all undergraduate and graduate full and part-time international students on an F-1/F-2 student visa or a J-1/J-2 student exchange visitor visa to be enrolled in an injury and sickness insurance program. Students will be required to participate in the University of Hartford's student Health Insurance Plan. We have partnered with Gallagher Koster and the United Healthcare Insurance Company to provide this service to you.  We strongly advise that you do not purchase health insurance in your home country, whether through your government, sponsoring agency, employer or private insurance company. In most instances it will not meet the University of Hartford's health insurance standards, which are compliant with the U.S. Federal Health Care Reform Law known as the "Patient Protection and Affordable Care Act" (PPACA). In addition, The University of Hartford will not accept "travel"  or "short-term" insurances polices which do not meet university health insurance standards; you may be required to spend additional funds to purchase the university policy or another policy that meets our standards.


Insurance Program Cost

The cost of this plan will automatically be added to your university billing charge at the time of your course registration each semester. The University estimates the cost of this insurance to be $1,290 for both undergraduate and graduate international students for the 2013-2014  year. (see below for the current fee and schedule).


Insurance Fees and Schedule for 2013-2014


     International Student Rates

Annual Coverage 

(09/01/2013 - 08/31/2014)

Fall Only Coverage

(09/01/2013 - 01/18/2014)

 Spring/Summer Coverage

(01/19/2014 - 08/31/2014)

     Student Rate



















Insurance Coverage Highlights

  • Up to $500,000 Maximum Benefit for each Injury or Sickness for Covered Medical Expenses

  • $100 Deductible for Preferred Providers Per Insured Person, Per Policy Year, $200 Deductible for Out of Network Providers Per Insured Person, Per Policy Year.

  • Covered Medical Expenses for Preferred Providers are payable at 80% of Preferred Allowance and Out of Network benefits are payable at 60% of Usual and Customary charges (all benefits are subject to satisfaction of the Deductible, specific benefit limitations, maximums and Copays as described in the policy).

  • Preferred Provider Out-of-Pocket Maximum of $5,000 Per Insured Person, Per Policy Year. Out-of-NetworkOut-of-Pocket maximum of $10,000 Per Insured Person, Per Policy Year. After the Out-of-Pocket Maximum has been satisfied, Covered Medical Expenses will be paid at 100% up to the policy Maximum Benefit subject to any applicable benefit maximums. Refer to the plan certificate for details about how the Out-of-Pocket Maximum applies.

  • Prescription Drug Benefits: $15 Copay for generic drugs / $30 Copay for brand name drugs/ $40 copay for brand name non-preferred drugs up to a 30-day supply per prescription filled at an Express Scripts Pharmacy network. Mail order through Express Scripts at 2.5 times the retail Copay up to a 90 day supply. $15 Deductible for generic drugs / $30 Deductible for brand name drugs / $40 Deductible for brand name non-preferred drugs up to a 31-day supply per Prescription at an Out-of-Network pharmacy.

  • Preventive Care Services which include, but are not limited to annual physicals, GYN exams, routine screenings and immunizations are covered at 100% with no Copay or Deductible only when the services are received from a Preferred Provider.

  • Coverage available for eligible Dependents.

  • The Preferred Providers for this plan are the UnitedHealthcare Options PPO.

  • FrontierMEDEX – Domestic Students are eligible for FrontierMEDEX services when 100 miles or more away from your campus address and 100 miles or more away from your permanent home address. International Students are covered worldwide except in their home country.

  • Also available for University of Hartford students is a UnitedHealthcare Insurance Company fully insured Dental plan, to enroll go to

  •  Accident coverage for intercollegiate sports injury is available provided under a separate policy #2013-1057-8.


Dependent Coverage (Spouse/Child)

The University of Hartford insurance program also offers coverage for a spouse or child(ren) at an additional cost. Dependents of an F-1 student are not required to have injury and sickness insurance coverage (unless enrolled as a full or part-time student), though the University strongly recommends coverage be purchased, particularly for a child(ren). Dependent(s) of a J-1 exchange visitor student must carry insurance that meets U.S. Department of State requirements (the university policy meets or exceeds these requirements).

Note:  An F-2  dependent who is enrolled as a student must have the required insurance coverage



Additional Optional Coverage


Dental Plan Coverage (Basix Dental Savings and Wellness)

The cost of dental care is a major concern to both students and health service administrators. To help with this issue, Gallagher Koster makes the Basix Dental Savings Program available to you. It is important to understand the Dental Savings Program is not dental insurance. Basix contracts with dentists that agree to charge a reduced fee to students covered under your Gallagher Koster plan. The student must pay for the services received at the time of service to receive the negotiated rate.

Savings vary but can be as high as 50% depending upon the type of service received and the specific contracted dentist providing the service. To use the program, simply:

  • Make an appointment with a contracted dentist; all the contracted dentists are listed on our website,
  • Make sure the dental office understands that you have access to the Basix program. We list an administrative contact person for each dentist to help clear up any confusion on the spot. We don't issue a separate identification card for the Basix program. The dentist's office may ask for your health plan identification card to make sure you have access to the program. If the office needs to check eligibility, call Gallagher Koster at the number on your ID Card.
  • Remember, you must pay for the services you receive at the time of service, so make sure you understand what forms of payment (check, credit card, etc.) the dentist accepts.


EyeMed Vision Care

This discount vision plan is available through EyeMed Vision Care. EyeMed's provider network consists of over 45,000 independent providers and retail stores nationwide, including LensCrafters, Pearle Vision, Sears Optical, Target Optical, JC Penney Optical, and many private practitioners.

This is not an insurance plan; there is no waiting period. Enrolled students can take advantage of the savings through EyeMed immediately upon receipt of their separate ID card. You can purchase prescription eyeglasses, conventional contact lenses or even non-prescription sunglasses at savings between 15% and 45% off regular retail pricing. In addition, you can receive discounts from 5% to 15% off laser correction surgery at some of the nation's most highly qualified laser correction surgeons.

Please click on the following link to download the EyeMed Flyer.

Please click on the following link to print an EyeMed ID Card: EyeMed ID Card.

To locate a participating provider, or if you have any additional questions, you can call 1-866-8EYEMED or go online at


University Waiver

The University has put in place a "waiver" process for qualifying F and J students. While insurance is required, a student may request a "waiver" from the University administered health insurance program by showing that they are already enrolled in a program which has coverage equal to or greater than the University policy. Qualifying students must request a waiver through the International Center. Waivers must be requested no later than the University's "Census Date" (October 5, 2013 for those students enrolling the Fall 2013 semester and February 22, 2014 for those students enrolling in the Spring 2014 semester.) Students requesting a waiver after the "Census" date will be denied their request for a waiver for that semester and billed for the University insurance policy. A decision on a request for a waiver will be made within five working days or less by the International Center. (See instructions below on how to Waiver the University of Hartford insurance policy).

     Waiver Eligibility

The requirement that you purchase the University of Hartford Student Health Insurance Plan may be waived only if you meet certain eligibility criteria and have comparable insurance that is valid in the U.S. Only students who fit into one of the following categories are eligible for an insurance waiver:

  • Student funded by his or her government, or the U.S. government.
  • Student receiving health insurance benefits provided by a U.S. employer of his or her parent, spouse or domestic partner.
  • Student enrolled at the University of Hartford but doing studies or research outside the U.S.
  • Student working in the U.S. and receiving health insurance benefits through his or her employer.
  • Student who has private health insurance that meets the University's minimum standards

     How to request a Waiver

  1. Complete a University Insurance Waiver Form

  2. Bring your waiver form and insurance policy coverage document to the international Center (an insurance ID card is not acceptable as the university is required to determine that your policy meets specific insurance limitations and coverage)

  3. Upon receipt of your Waiver request and supporting documentation and approval of your Waiver request, the International Center will update your University account with the Bursar's Office.  The charge for insurance will be removed from your account and that information will be sent to Gallagher Koster

Your insurance should meet these minimum requirements to be eligible for a Waiver (other requirements may be applicable):

  • Plan must be one year duration

  • Company must be U.S. based and the address to submit claims must be in the U.S.  

  • Plan minimum coverage of at least $500,000 per policy year

  • Deductible no greater than $100 for preferred providers/Preferred Provider Out-of-Pocket Maximum of $5,000 per insured person,

  • Wellness/preventative at 100% with no co-payments

  • No internal benefit caps on coverage categories (diagnostics, lab, hospital, R&B, pharmacy, mental health, etc.)

  • Travel assistance for medical evacuation and repatriation

  • pre-existing condition coverage after 6 months

  • No waiting periods for pre-existing conditions for students 19 or younger



  • A private insurance policy must be issued from a U.S. based company. Insurance policies issued to you from non U.S. based insurance companies will not be accepted. Insurance policies issued for "Short-term"  or "Travel" are not considered comparable coverage

  • Waivers for the 2013-2014 academic year will be processed through the International Center.  If the International Center  cannot determine whether a non-university insurance policy meets specified requirements, the Center will consult with Gallagher Koster to determine final Waiver eligibility.


The University DOES NOT recommend non-university health insurance providers to its students. If you are Waived from the University policy, it is your responsibility to insure that you have continued coverage for the duration of the waived period and that your policy meets both Federal and University requirements. The University assumes no liability should you choose to waive the University's policy or discontinue your insurance coverage. If you choose to discontinue a non-university insurance policy, you are required to enroll in the University health care program and MUST inform the International Center.



Who to Contact

Questions regarding this insurance policy (including coverage limitations) should be addressed to Gallagher Koster or the International Center (GSU 327).  You may view the Policy Coverage Limitations and the Frequently Asked Questions information document at these sites



Medical Claim Form

You may download a copy of the Medical Claim Form here



How to get a copy of your insurance card

Students that are enrolled in the University of Hartford program may download a copy of their insurance card and policy information through our insurance company’s website.

Here are instructions on how to do that.

Step 1: Go to the link:

Step 2: Create an account


Step 3: Go to Authorize Account and sign in using your University of Hartford student ID and birth date.


Step 4: Print out your insurance card.





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