STUDENT HEALTH PLAN 2020-2021 - NYU

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STUDENT HEALTH PLAN 2020-2021 - NYU
2020-2021

                               STUDENT HEALTH PLAN
                                      TANDON SCHOOL OF
                                        ENGINEERING

                                        ("the Policyholder")
                               Policy Number: WNY2021NYSHIP04
                                    Group Number: ST0645SH
                                Effective: 8/21/2020 – 8/20/2021

      Underwritten By:                   Provider Network:          Administered By:
                                                                   Wellfleet Group, LLC
Wellfleet New York Insurance
    Co. ("the Company")
STUDENT HEALTH PLAN 2020-2021 - NYU
NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

WHAT’S INSIDE (Click on section header below to go to section in brochure.)
      Student Health and Insurance at NYU ...........................................................................................................................3
      Confidentiality ...............................................................................................................................................................3
      Patient Protection and Affordable Care Act (PPACA) ....................................................................................................4
      Student Health Insurance Plan Overview ......................................................................................................................4
      Information for Graduate Employees NYU/UAW Local 2110 ........................................................................................5
      Schedule of Benefits ......................................................................................................................................................5
             Accidental Death and Dismemberment ..............................................................................................................22
             Preauthorization Procedure ................................................................................................................................23
             Student Health Insurance Plan Costs ...................................................................................................................23
             Insurance Payment Options ................................................................................................................................24
             Insurance Cards ...................................................................................................................................................24
      Enrolling in the Student Health Insurance Plan ...........................................................................................................24
             Eligibility...............................................................................................................................................................24
             Automatic Enrollment .........................................................................................................................................25
             Voluntary Enrollment ..........................................................................................................................................25
             Dependents .........................................................................................................................................................25
             How to Enroll .......................................................................................................................................................26
             Enrollment Deadlines ..........................................................................................................................................26
             Important Enrollment Rules for Matriculated Students ......................................................................................26
             Fall 2020/Spring 2021 Automatic Enrollment Guide ...........................................................................................27
             Special Enrollment Periods ..................................................................................................................................27
      Waiving the Student Health Insurance Plan ................................................................................................................28
             Waiver Criteria Applicable to All Students ..........................................................................................................28
             How to Waive Online ...........................................................................................................................................29
             Waiver Deadlines .................................................................................................................................................29
             Important Waiver Rules .......................................................................................................................................29
      International Students in F-1 or J-1 Visa Status ...........................................................................................................30
             International Students Waiver Process ...............................................................................................................30
      Information for Parents ...............................................................................................................................................31
      Exclusions and Limitations ...........................................................................................................................................32
      Claim Procedures .........................................................................................................................................................34
      Grievances, Utilization Review, and Appeals...............................................................................................................34
      Definitions ...................................................................................................................................................................35
      Contact Information (pp. 41-42) ..................................................................................................................................41
      Students Studying Away Insurance Program ...............................................................................................................43
      Information for Graduate Employees NYU/UAW Local 2110 ......................................................................................43
      Stu-Dent Dental Health Program .................................................................................................................................43

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                                                       Wellfleet Student PO Box 15369 Springfield, MA 01115-5369
NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

Student Health and Insurance at NYU
    New York University values the health of its students and is committed to offering all students access to quality
    healthcare and reasonably priced health insurance plans to help protect against financial hardships that may result
    from high healthcare expenses.

    While most undergraduate and graduate students are in good health and face few serious illnesses while in school,
    medical and psychological issues can arise at any time, sometimes without warning. There are also certain health
    concerns that may become apparent for the first time in early adulthood.

    The high cost of healthcare in the United States presents a potentially serious financial risk to students. The absence
    of adequate insurance coverage can result in temporary or permanent interruption of Your education; therefore,
    NYU requires that all students registered in degree-granting programs maintain health insurance.

    Most students are automatically enrolled in and charged Premium for the NYU sponsored student health insurance
    plan (NYU sponsored plan) as part of the course registration process. Students who maintain alternate health
    insurance coverage that meets the University’s minimum health insurance criteria may waive the NYU sponsored
    student health insurance plan entirely (see Waiving the Student Health Insurance Plan section).

    This brochure has been prepared to help You understand the benefits and levels of coverage the NYU sponsored
    student health insurance plan offers.

    Student Health Center Locations

    Manhattan
    726 Broadway, 2nd, 3rd, and 4th Floors
    New York, NY 10003
    (212) 443-1000

    Brooklyn
    6 MetroTech Center, ROG-B020
    Brooklyn, NY 11201
    (646) 997-3456

Confidentiality
    Your privacy is Our priority. The Student Health Center (SHC) is legally and ethically obligated to protect the privacy
    of a student’s health information.

    Treatment of student health information is governed by the Family Educational Rights and Privacy Act (FERPA) and
    the requirements of applicable New York State law. The SHC will only disclose this information in limited
    circumstances in accordance with applicable law.

    The SHC will not release medical information to anyone, including family, parents/legal guardians, NYU faculty/staff,
    or outside agencies, without the written authorization of the student, except in emergency situations or to comply
    with a subpoena or judicial order. In the case of a minor, the authorization of a parent or legal guardian is required
    to release medical records. In a medical emergency, only relevant health information will be released to another
    healthcare Provider.

    The underwriter and administrator of the NYU-sponsored student health insurance plan also handle student health
    information in connection with the operation of the plan. Treatment of such information is governed by the Health
    Insurance Portability and Accountability Act (HIPAA) and the requirements of applicable New York State law.

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                                    Wellfleet Student PO Box 15369 Springfield, MA 01115-5369
NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

Patient Protection and Affordable Care Act (PPACA)
    The Affordable Care Act (ACA) was enacted to increase the availability of health insurance coverage to more
    Americans. There are a multitude of medical coverage requirements and it is important for You to know that the
    NYU sponsored student health insurance plan is fully ACA compliant.

    Here’s additional information about the ACA to assist You in making coverage decisions:

    Students are eligible to remain on a parent’s plan until age 26. However, You should compare the cost and benefits
    of coverage under a parent’s plan to those of the NYU sponsored student health insurance plan.

    Employer plans held by You or Your parents may be local HMO’s that are not appropriate for a student attending
    school out of state.

    The ACA created health insurance marketplaces for individuals to obtain coverage. However, You should carefully
    review the terms of the coverage to compare with any other alternatives including in terms of: Deductibles,
    Copayments, Coinsurance, and limited Provider networks. If You are interested in exploring this option, the web site
    is www.healthcare.gov. You will be directed to the appropriate online marketplace for Your home state of residence.

    Generally, international students holding an F-1 or J-1 visa are not eligible to purchase insurance through the
    marketplaces because they must show permanent residency.

Student Health Insurance Plan Overview
    Wellfleet Student Health Insurance Plan
    The NYU sponsored student health insurance plan, administered by Wellfleet Group, LLC, is designed to provide
    reasonably priced healthcare coverage. The insurance plan supplements the free services (as does any other health
    insurance) provided at the SHC. The NYU sponsored student health insurance plan covers most medical treatments
    and procedures provided at the SHC, for which there is a fee, as well as national coverage for medically necessary
    healthcare services.

    All matriculated students are eligible for enrollment in the Student Health Insurance Plan sponsored by NYU. See
    Voluntary Enrollment section for more information about enrolling Dependents and other eligible enrollees.

    The Insurance consists of the Tandon Student Health Insurance Plan designed to provide reasonably priced
    healthcare coverage.

    The plan offers coverage for services rendered by healthcare Providers who participate in the Cigna PPO network.
    Visit www.wellfleetstudent.com/nyu to search for Cigna PPO Providers. Out-of-network Providers are also
    covered but at a lower reimbursement level. (See Schedule of Benefits).

    Please note: The SHC is an in-network Preferred Provider under the NYU sponsored student health insurance plan
    underwritten by Wellfleet New York Insurance Company.

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                                    Wellfleet Student PO Box 15369 Springfield, MA 01115-5369
NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

  Information for Graduate Employees NYU/UAW Local 2110
        Effective September 1, 2015, the University began providing its student health insurance plan (Basic Health Plan –
        Individual Coverage) at 10% of the applicable premium rate to eligible graduate student employees. In addition,
        eligible graduate student employees will be covered by the Stu-Dent Plan for NYU at no cost and will be automatically
        enrolled in the Stu-Dent Plan upon confirmation of union eligibility.

        For eligible Tandon graduate student employees, a Basic Health Plan insurance charge may initially appear on the
        graduate student employee’s tuition bill, but will be adjusted when the student’s union eligibility is confirmed. At
        that time the insurance charge on the Bursar account will be adjusted to 10% of the Basic Health Insurance Plan
        charge for that term.

        Dependent Coverage Premium Support Plan

        Effective September 1, 2015, the University established a Graduate Employee Student Health Insurance Dependent
        Premium Support Plan. For Academic Year 2019-2020, the Plan will be funded with $200,000, divided equally
        between the fall and spring semesters.

        Those eligible graduate employees who are doctoral candidates who actually purchase dependent coverage under
        the Basic Student Health Insurance Plan and provide proof thereof, may, during the subject semester, apply for up
        to 75% reimbursement of dependent coverage premiums. Actual reimbursement will depend on the number of
        applications and the funds allocated for that semester. Unused funds, if any, will not carry over to a future semester.
        The application deadline for reimbursement for fall 2019 is January 8, 2020 and for spring 2020 is August 20, 2020.

  Schedule of Benefits
        Availability of services at SHC locations varies, please verify location when making appointments.

        For a more complete description of plan benefits, general terms and conditions, Preauthorization requirements, etc.,
        please review the 2020-2021 Student Health Insurance Certificate at www.wellfleetstudent.com/nyu.

                             NYU TANDON SCHOOL OF ENGINEERING SCHEDULE OF BENEFITS
                                             Metal Level: Platinum
                                        NYU Tandon School of Engineering

Policy Number: WNY2021NYSHIP04
Group/Plan Number: ST0645SH
Policyholder Effective Date: August 21, 2020
Policyholder Termination Date: August 20, 2021

COST-SHARING               Student Health Center         Participating Provider            Non-Participating
                           Member Responsibility         Member Responsibility             Provider Member
                           for Cost-Sharing              for Cost-Sharing                  Responsibility for
                                                                                           Cost-Sharing
Medical
Deductible
• Individual               $0                            $0                                $100

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                                        Wellfleet Student PO Box 15369 Springfield, MA 01115-5369
NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

COST-SHARING               Student Health Center        Participating Provider            Non-Participating
                           Member Responsibility        Member Responsibility             Provider Member
                           for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                          Cost-Sharing

Out-of-Pocket Limit
• Individual               $6,350                       $6,350                            $6,350

•   Family                 $12,700                      $12,700                           $12,700

Accidental Death and                                                                      See the Cost-Sharing
Dismemberment                                                                             Expenses and Allowed
Benefits                                                                                  Amount section of this
$10,000                                                                                   Certificate for a
Annual and Lifetime                                                                       description of how We
Maximum.                                                                                  calculate the Allowed
                                                                                          Amount.
                                                                                          Any charges of a Non-
                                                                                          Participating Provider
                                                                                          that are in excess of
                                                                                          the Allowed Amount
                                                                                          do not apply towards
                                                                                          the Deductible or Out-
                                                                                          of-Pocket Limit. You
                                                                                          must pay the amount
                                                                                          of the Non-
                                                                                          Participating Provider’s
                                                                                          charge that exceeds
                                                                                          Our Allowed Amount.

OFFICE VISITS              Student Health Center        Participating Provider            Non-Participating          Limits
                           Member Responsibility        Member Responsibility             Provider Member
                           for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                          Cost-Sharing
Primary Care Office        Covered in full              $20 Copayment                     30% Coinsurance after      See benefit for
Visits                                                  0% Coinsurance                    Deductible                 description
(or Home Visits)

Specialist Office Visits   Covered in full              $20 Copayment                     30% Coinsurance after      See benefit for
(or Home Visits)                                        0% Coinsurance                    Deductible                 description

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                                       Wellfleet Student PO Box 15369 Springfield, MA 01115-5369
NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

PREVENTIVE CARE           Student Health Center        Participating Provider            Non-Participating        Limits
                          Member Responsibility        Member Responsibility             Provider Member
                          for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                         Cost-Sharing
•   Well Child Visits     Covered in full              Covered in full                   30% Coinsurance after    See benefit for
    and                                                                                  Deductible               description
    Immunizations*

•   Adult Annual          Covered in full              Covered in full                   30% Coinsurance after
       Physical                                                                          Deductible
    Examinations*

•   Adult                 Covered in full              Covered in full                   30% Coinsurance after
    Immunizations*                                                                       Deductible

•   Routine               Covered in full              Covered in full                   30% Coinsurance after
    Gynecological                                                                        Deductible
    Services/Well
    Woman Exams*

•   Mammograms,           Covered in full              Covered in full                   30% Coinsurance after
    Screening and                                                                        Deductible
    Diagnostic
    Imaging for the
    Detection of
    Breast Cancer

•   Sterilization         Covered in full              Covered in full                   30% Coinsurance after
    Procedures for                                                                       Deductible
    Women*

•   Vasectomy             Covered in full              $20 Copayment]                    30% Coinsurance after
                                                       0% Coinsurance                    Deductible

•   Bone Density          Covered in full              Covered in full                   40% Coinsurance
    Testing*                                                                             after Deductible

•   Screening for         Covered in full              Covered in full                   30% Coinsurance after
    Prostate Cancer                                                                      Deductible

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                                      Wellfleet Student PO Box 15369 Springfield, MA 01115-5369
NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

PREVENTIVE CARE          Student Health Center        Participating Provider            Non-Participating         Limits
                         Member Responsibility        Member Responsibility             Provider Member
                         for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                        Cost-Sharing

•   All other            Covered in Full              Covered in full                   30% Coinsurance after
    preventive                                                                          Deductible
    services required
    by USPSTF and
    HRSA.

*When preventive         Use Cost-Sharing for         Use Cost-Sharing for              Use Cost-Sharing for
services are not         appropriate service          appropriate service               appropriate service
provided in              (Primary Care Office         (Primary Care Office Visit        (Primary Care Office
accordance with the      Visit Specialist Office      Specialist Office Visit           Visit Specialist Office
comprehensive            Visit Diagnostic             Diagnostic Radiology              Visit Diagnostic
guidelines supported     Radiology Services           Services Laboratory               Radiology Services
by USPSTF and HRSA.      Laboratory Procedures        Procedures and                    Laboratory Procedures
                         and Diagnostic Testing)      Diagnostic Testing)               and Diagnostic Testing)

EMERGENCY CARE           Student Health Center        Participating Provider            Non-Participating         Limits
                         Member Responsibility        Member Responsibility             Provider Member
                         for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                        Cost-Sharing

Pre-Hospital             N/A                          Covered in full                   Covered in full           See benefit for
Emergency Medical                                                                                                 description
Services
(Ambulance Services)

Non-Emergency            N/A                          Covered in full                   Covered in full           See benefit for
Ambulance Services                                                                                                description

Emergency                N/A                          $50 Copayment                     $50 Copayment             See benefit for
Department                                            10% Coinsurance                   10% Coinsurance not       description
                                                                                        subject to Deductible
Copayment waived if      Health care forensic         Health care forensic
Hospital admission       examinations                 examinations performed
                         performed under Public       under Public Health Law
                         Health Law § 2805-I are      § 2805-I are not subject
                         not subject to Cost-         to Cost-Sharing
                         Sharing

Urgent Care Center       N/A                          $20 Copayment                     30% Coinsurance after     See benefit for
                                                      0% Coinsurance                    Deductible                description

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                                     Wellfleet Student PO Box 15369 Springfield, MA 01115-5369
NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

PROFESSIONAL              Student Health Center        Participating Provider            Non-Participating        Limits
SERVICES and              Member Responsibility        Member Responsibility             Provider Member
OUTPATIENT CARE           for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                         Cost-Sharing
Advanced Imaging                                                                                                  See benefit for
Services                                                                                                          description

•   Performed in a        N/A                          10% Coinsurance                   40% Coinsurance after
    Specialist Office                                                                    Deductible

•   Performed in a        N/A                          10% Coinsurance                   40% Coinsurance after
    Freestanding                                                                         Deductible
    Radiology Facility

•   Performed as          N/A                          10% Coinsurance                   40% Coinsurance after
    Outpatient                                                                           Deductible
    Hospital Services

Preauthorization
Required
Allergy Testing and                                                                                               See benefit for
Treatment                                                                                                         description

•   Performed in a        Covered in full              $20 Copayment                     30% Coinsurance after
    PCP Office                                         0% Coinsurance                    Deductible

•  Performed in a         Covered in full              $20 Copayment                     30% Coinsurance after
   Specialist Office                                   0% Coinsurance                    Deductible
Ambulatory Surgical       N/A                          10% Coinsurance                   40% Coinsurance after    See benefit for
Center Facility Fee                                                                      Deductible               description

Preauthorization
Required
Anesthesia Services       N/A                          10% Coinsurance                   40% Coinsurance after    See benefit for
(all settings)                                                                           Deductible               description
Autologous Blood          N/A                          10% Coinsurance                   40% Coinsurance after    See benefits
Banking                                                                                  Deductible               for description
Cardiac and                                                                                                       See benefits
Pulmonary                                                                                                         for description
Rehabilitation

•   Performed in a        N/A                          10% Coinsurance                   30% Coinsurance after
    Specialist Office                                                                    Deductible

•   Performed as          N/A                          10% Coinsurance                   30% Coinsurance after
    Outpatient                                                                           Deductible
    Hospital Services

•   Performed as          N/A                          Included as part of        Included as part of
    Inpatient Hospital                                 inpatient Hospital service inpatient Hospital
    Services                                           Cost-Sharing               service Cost-Sharing

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                                      Wellfleet Student PO Box 15369 Springfield, MA 01115-5369
NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

PROFESSIONAL              Student Health Center        Participating Provider            Non-Participating        Limits
SERVICES and              Member Responsibility        Member Responsibility             Provider Member
OUTPATIENT CARE           for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                         Cost-Sharing
Chemotherapy                                                                                                      See benefit for
                                                                                                                  description
•   Performed in a        N/A                          10% Coinsurance                   40% Coinsurance after
    PCP Office                                                                           Deductible

•   Performed in a        N/A                          10% Coinsurance                   40% Coinsurance after
    Specialist Office                                                                    Deductible

•   Performed as          N/A                          10% Coinsurance                   40% Coinsurance after
    Outpatient                                                                           Deductible
    Hospital Services
Preauthorization
Required
Chiropractic Services     N/A                          $20 Copayment                     30% Coinsurance after    See benefit for
                                                       0% Coinsurance                    Deductible               description
Preauthorization
Required
Clinical Trials           Use Cost-Sharing for         Use Cost-Sharing for              Use Cost-Sharing for     See benefit for
                          appropriate service          appropriate service               appropriate service      description
Diagnostic Testing                                                                                                See benefit for
                                                                                                                  description
•   Performed in a        10% Coinsurance              10% Coinsurance                   40% Coinsurance after
    PCP Office                                                                           Deductible

•   Performed in a        10% Coinsurance              10% Coinsurance                   40% Coinsurance after
    Specialist Office                                                                    Deductible

•   Performed as          N/A                          10% Coinsurance                   40% Coinsurance after
    Outpatient                                                                           Deductible
    Hospital Services
Dialysis                                                                                                          See benefit for
                                                                                                                  description
•   Performed in a        N/A                          $20 Copayment                     30% Coinsurance after
    PCP Office                                         0% Coinsurance                    Deductible

•   Performed in a        N/A                          $20 Copayment                     30% Coinsurance after
    Specialist Office                                  0% Coinsurance                    Deductible

•   Performed in a        N/A                          $20 Copayment                     30% Coinsurance after
    Freestanding                                       0% Coinsurance                    Deductible
    Center

•   Performed as          N/A                          10% Coinsurance                   40% Coinsurance after
    Outpatient                                                                           Deductible
    Hospital Services

•   Performed at          N/A                          10% Coinsurance                   40% Coinsurance after
    Home                                                                                 Deductible
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                                      Wellfleet Student PO Box 15369 Springfield, MA 01115-5369
NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

PROFESSIONAL               Student Health Center        Participating Provider            Non-Participating          Limits
SERVICES and               Member Responsibility        Member Responsibility             Provider Member
OUTPATIENT CARE            for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                          Cost-Sharing
Habilitation Services      10% Coinsurance              10% Coinsurance                   40% Coinsurance after      60 visits per
(Physical Therapy,                                                                        Deductible                 condition, per
Occupational Therapy                                                                                                 Plan Year
or Speech Therapy)                                                                                                   combined
                                                                                                                     therapies

Home Health Care           N/A                          10% Coinsurance                   40% Coinsurance after      40 visits per
                                                                                          Deductible                 Plan Year
Preauthorization
Required
Infertility Services       Use Cost-Sharing for         Use Cost-Sharing for              Use Cost-Sharing for       See benefit for
                           appropriate service          appropriate service               appropriate service        description
                           (Office Visit Diagnostic     (Office Visit Diagnostic          (Office Visit Diagnostic
                           Radiology Services           Radiology Services                Radiology Services
                           Surgery Laboratory &         Surgery Laboratory &              Surgery Laboratory &
                           Diagnostic Procedures)       Diagnostic Procedures)            Diagnostic Procedures)
Infusion Therapy                                                                                                     See benefit for
                                                                                                                     description
•   Performed in a         Covered in full              $20 Copayment                     30% Coinsurance after
    PCP Office                                          0% Coinsurance                    Deductible

•   Performed in           Covered in full              $20 Copayment                     30% Coinsurance after
    Specialist Office                                   0% Coinsurance                    Deductible

•   Performed as           N/A                          10% Coinsurance                   40% Coinsurance after
    Outpatient                                                                            Deductible
    Hospital Services

•   Home Infusion          N/A                          10% Coinsurance                   40% Coinsurance after      Home infusion
    Therapy                                                                               Deductible                 counts toward
                                                                                                                     home health
                                                                                                                     care visit limits
Inpatient Medical          N/A                          10% Coinsurance                   40% Coinsurance after      See benefit for
Visits                                                                                    Deductible                 description
Interruption of
Pregnancy

•   Medically              N/A                          Covered in full                   40% Coinsurance after      Unlimited
    Necessary                                                                             Deductible
    Abortions

•   Elective Abortions     N/A                          10% Coinsurance                   40% Coinsurance after      One (1)
                                                                                          Deductible                 procedure per
                                                                                                                     Plan Year

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                                       Wellfleet Student PO Box 15369 Springfield, MA 01115-5369
NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

PROFESSIONAL              Student Health Center        Participating Provider            Non-Participating          Limits
SERVICES and              Member Responsibility        Member Responsibility             Provider Member
OUTPATIENT CARE           for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                         Cost-Sharing
Laboratory                                                                                                          See benefit for
Procedures                                                                                                          description

•   Performed in a        10% Coinsurance              10% Coinsurance                   40% Coinsurance after
    PCP Office                                                                           Deductible

•   Performed in a        N/A                          10% Coinsurance                   40% Coinsurance after
    Specialist Office                                                                    Deductible

•   Performed in a      N/A                            10% Coinsurance                   40% Coinsurance after
    Freestanding                                                                         Deductible
    Laboratory Facility

•   Performed as          N/A                          10% Coinsurance                   40% Coinsurance after
    Outpatient                                                                           Deductible
    Hospital Services

Maternity and                                                                                                       See benefit for
Newborn Care                                                                                                        description

• Prenatal Care           N/A                          Covered in full                   30% Coinsurance after
  provided in                                                                            Deductible
  accordance with
  the comprehensive
  guidelines
  supported by
  USPSTF and HRSA

• Prenatal Care that      Use Cost-Sharing for         Use Cost-Sharing for              Use Cost-Sharing for
  is not provided in      appropriate service          appropriate service               appropriate service
  accordance with         (Primary Care Office         (Primary Care Office              (Primary Care Office
  the comprehensive       Visit, Specialist Office     Visit, Specialist Office          Visit, Specialist Office
  guidelines              Visit, Diagnostic            Visit, Diagnostic                 Visit, Diagnostic
  supported by            Radiology Services,          Radiology Services,               Radiology Services,
  USPSTF and HRSA         Laboratory Procedures        Laboratory Procedures             Laboratory Procedures
                          and Diagnostic Testing)      and Diagnostic Testing)           and Diagnostic Testing)

• Inpatient Hospital      N/A                          10% Coinsurance                   40% Coinsurance after
  Services and                                                                           Deductible                 One (1) home
  Birthing Center                                                                                                   care visit is
                                                                                                                    covered at no
• Physician and           N/A                          10% Coinsurance                   40% Coinsurance after      Cost-Sharing if
  Midwife Services                                                                       Deductible                 mother is
  for Delivery                                                                                                      discharged
                                                                                                                    from Hospital
                                                                                                                    early

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                                      Wellfleet Student PO Box 15369 Springfield, MA 01115-5369
NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

PROFESSIONAL              Student Health Center        Participating Provider            Non-Participating        Limits
SERVICES and              Member Responsibility        Member Responsibility             Provider Member
OUTPATIENT CARE           for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                         Cost-Sharing
Maternity and                                                                                                     Maternity and
Newborn Care                                                                                                      Newborn Care
(continued)                                                                                                       (continued)

•   Breastfeeding         N/A                          Covered in full                   30% Coinsurance after    Covered for
    Support,                                                                             Deductible               duration of
    Counseling and                                                                                                breast feeding
    Supplies, Including
    Breast Pumps

•   Postnatal Care        N/A                          $20 Copayment                     30% Coinsurance after
                                                       0% Coinsurance                    Deductible
Preauthorization
Required

Outpatient Hospital       N/A                          10% Coinsurance                   40% Coinsurance after    See benefit for
Surgery Facility                                                                         Deductible               description
Charge

Preauthorization
Required

Preadmission Testing      N/A                          10% Coinsurance                   40% Coinsurance after    See benefit for
                                                                                         Deductible               description

Prescription Drugs                                                                                                See benefit for
Administered in Office                                                                                            description
or Outpatient
Facilities

•   Performed in a        Covered in full              Covered in full                   30% Coinsurance after
    PCP Office                                                                           Deductible

•   Performed in          Covered in full              Covered in full                   30% Coinsurance after
    Specialist Office                                                                    Deductible

•   Performed in          N/A                          10% Coinsurance                   40% Coinsurance after
    Outpatient                                                                           Deductible
    Facilities

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PROFESSIONAL              Student Health Center        Participating Provider            Non-Participating        Limits
SERVICES and              Member Responsibility        Member Responsibility             Provider Member
OUTPATIENT CARE           for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                         Cost-Sharing
Diagnostic Radiology                                                                                              See benefit for
Services                                                                                                          description

•   Performed in a        10% Coinsurance              10% Coinsurance                   40% Coinsurance after
    PCP Office                                                                           Deductible

•   Performed in a        N/A                          10% Coinsurance                   40% Coinsurance after
    Specialist Office                                                                    Deductible

•   Performed in a        N/A                          10% Coinsurance                   40% Coinsurance after
    Freestanding                                                                         Deductible
    Radiology Facility

•   Performed as          N/A                          10% Coinsurance                   40% Coinsurance after
    Outpatient                                                                           Deductible
    Hospital Services

Preauthorization
Required
Therapeutic Radiology                                                                                             See benefit for
Services                                                                                                          description

•   Performed in a        N/A                          10% Coinsurance                   40% Coinsurance after
    Specialist Office                                                                    Deductible

•   Performed in a        N/A                          10% Coinsurance                   40% Coinsurance after
    Freestanding                                                                         Deductible
    Radiology Facility

•   Performed as          N/A                          10% Coinsurance                   40% Coinsurance after
    Outpatient                                                                           Deductible
    Hospital Services

Preauthorization
Required
Rehabilitation        10% Coinsurance                  10% Coinsurance                   40% Coinsurance after    60 visits per
Services (Physical                                                                       Deductible               condition, per
Therapy, Occupational                                                                                             Plan Year
Therapy or Speech                                                                                                 combined
Therapy)                                                                                                          therapies

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NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

PROFESSIONAL             Student Health Center        Participating Provider            Non-Participating          Limits
SERVICES and             Member Responsibility        Member Responsibility             Provider Member
OUTPATIENT CARE          for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                        Cost-Sharing
Second Opinions on       Covered in full              $20 Copayment                     30% Coinsurance after      See benefit for
the Diagnosis of                                      0% Coinsurance                    Deductible                 description
Cancer,
Surgery and Other                                                                       Second opinions on
                                                                                        diagnosis of cancer are
                                                                                        Covered at
                                                                                        participating Cost-
                                                                                        Sharing for non-
                                                                                        participating Specialist
                                                                                        when a Referral is
                                                                                        obtained.
Surgical Services                                                                                                  See benefit for
(including Oral                                                                                                    description
Surgery
Reconstructive Breast
Surgery Other
Reconstructive and
Corrective Surgery;
and Transplants

•   Inpatient Hospital   N/A                          10% Coinsurance                   40% Coinsurance after
    Surgery                                                                             Deductible

•   Outpatient           N/A                          10% Coinsurance                   40% Coinsurance after
    Hospital Surgery                                                                    Deductible

•   Surgery              N/A                          10% Coinsurance                   40% Coinsurance after
    Performed at an                                                                     Deductible
    Ambulatory
    Surgical Center

•   Office Surgery       10% Coinsurance              10% Coinsurance                   40% Coinsurance after
                                                                                        Deductible
Preauthorization
Required
ADDITIONAL               Student Health Center        Participating Provider            Non-Participating          Limits
SERVICES,                Member Responsibility        Member Responsibility             Provider Member
EQUIPMENT and            for Cost-Sharing             for Cost-Sharing                  Responsibility for
DEVICES                                                                                 Cost-Sharing
ABA Treatment for        Covered in full              $20 Copayment                     30% Coinsurance after      See benefit
Autism Spectrum                                       0% Coinsurance                    Deductible                 description
Disorder
Assistive                Covered in full              $20 Copayment                     30% Coinsurance after      See benefit for
Communication                                         0% Coinsurance                    Deductible                 description
Devices for Autism
Spectrum Disorder

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NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

ADDITIONAL                Student Health Center        Participating Provider            Non-Participating        Limits
SERVICES,                 Member Responsibility        Member Responsibility             Provider Member
EQUIPMENT and             for Cost-Sharing             for Cost-Sharing                  Responsibility for
DEVICES                                                                                  Cost-Sharing
Diabetic Equipment,                                                                                               See benefit for
Supplies and Self-                                                                                                description
Management
Education                                                                                                         See
                                                                                                                  Prescription
Diabetic Equipment,       See the Prescription         See the Prescription              See the Prescription     Drug benefit
Supplies and Insulin      Drug Cost-Sharing            Drug Cost-Sharing                 Drug Cost-Sharing
(up to a 90 day
supply)

•  Diabetic               Covered in full              $20 Copayment                     30% Coinsurance after
   Education                                           0% Coinsurance                    Deductible
Durable Medical           10% Coinsurance              10% Coinsurance                   40% Coinsurance after    See benefit for
Equipment and Braces                                                                     Deductible               description

External Hearing Aids     N/A                          10% Coinsurance                   40% Coinsurance after    Single
                                                                                         Deductible               purchase once
                                                                                                                  every 3 years
Cochlear Implants         N/A                          10% Coinsurance                   40% Coinsurance after    One per ear
                                                                                         Deductible               per time
Preauthorization                                                                                                  Covered
Required
Hospice Care

•   Inpatient             N/A                          10% Coinsurance                   40% Coinsurance after    210 days per
                                                                                         Deductible               Plan Year

•   Outpatient            N/A                          10% Coinsurance                   40% Coinsurance after    Five (5) visits
                                                                                         Deductible               for family
                                                                                                                  bereavement
                                                                                                                  counseling
Medical Supplies          10% Coinsurance              10% Coinsurance                   40% Coinsurance after    See benefit for
                                                                                         Deductible               description

Prosthetic Devices

•   External              10% Coinsurance              10% Coinsurance                   40% Coinsurance after    One (1)
                                                                                         Deductible               prosthetic
                                                                                                                  device, per
                                                                                                                  limb, per
                                                                                                                  lifetime

•   Internal              N/A                          10% Coinsurance                   40% Coinsurance after    Unlimited
                                                                                         Deductible
                                                                                                                  See benefit for
                                                                                                                  description

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NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

INPATIENT SERVICES         Student Health Center       Participating Provider            Non-Participating        Limits
and FACILITIES             Member Responsibility       Member Responsibility             Provider Member
                           for Cost-Sharing            for Cost-Sharing                  Responsibility for
                                                                                         Cost-Sharing
Inpatient Hospital for N/A                             10% Coinsurance                   40% Coinsurance after    See benefit for
a Continuous                                                                             Deductible               description
Confinement
(including an Inpatient
Stay for Mastectomy
Care, Cardiac and
Pulmonary
Rehabilitation, and
End of Life Care)

Preauthorization
Required. However,
Preauthorization is
not required for
emergency
admissions or
services provided in a
neonatal intensive
care unit of a Hospital
certified pursuant to
Article 28 of the
Public Health Law.

Observation Stay           N/A                         10% Coinsurance                   40% Coinsurance after    See benefit for
                                                                                         Deductible               description

Skilled Nursing Facility   N/A                         10% Coinsurance                   40% Coinsurance after    200 days per
(including Cardiac and                                                                   Deductible               Plan Year
Pulmonary
Rehabilitation)                                                                                                   See benefit for
                                                                                                                  description
Preauthorization
Required

Inpatient Habilitation     N/A                         10% Coinsurance                   40% Coinsurance after    Unlimited days
Services (Physical                                                                       Deductible
Speech and                                                                                                        See benefit for
Occupational                                                                                                      description
Therapy)

Preauthorization
Required

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NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

INPATIENT SERVICES        Student Health Center        Participating Provider            Non-Participating        Limits
and FACILITIES            Member Responsibility        Member Responsibility             Provider Member
                          for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                         Cost-Sharing
Inpatient                 N/A                          10% Coinsurance                   40% Coinsurance after    Unlimited days
Rehabilitation                                                                           Deductible
Services (Physical                                                                                                See benefit for
Speech and                                                                                                        description
Occupational
Therapy)

Preauthorization
Required

MENTAL HEALTH and         Student Health Center        Participating Provider            Non-Participating        Limits
SUBSTANCE USE             Member Responsibility        Member Responsibility             Provider Member
DISORDER SERVICES         for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                         Cost-Sharing
Inpatient Mental          N/A                          10% Coinsurance                   40% Coinsurance after    See benefit for
Health Care for a                                                                        Deductible               description
continuous
confinement when in
a Hospital
(including Residential
Treatment)

Preauthorization
Required. However,
Preauthorization is
not required for
emergency
admissions or for
admissions at
Participating OMH-
licensed Facilities for
Members under 18.

Outpatient Mental         Covered in full              $20 Copayment                     30% Coinsurance after    See benefit for
Health Care                                            0% Coinsurance                    Deductible               description
(including Partial
Hospitalization and
Intensive Outpatient
Program Services)

Except for Office
Visits,
Preauthorization
Required

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NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

MENTAL HEALTH and        Student Health Center        Participating Provider            Non-Participating        Limits
SUBSTANCE USE            Member Responsibility        Member Responsibility             Provider Member
DISORDER SERVICES        for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                        Cost-Sharing

Inpatient Substance      N/A                          10% Coinsurance                   40% Coinsurance after    See benefit for
Use Services                                                                            Deductible               description
for a continuous
confinement when in
a Hospital
(including Residential
Treatment)

Preauthorization
Required. However,
Preauthorization is
Not Required for
Emergency
Admissions or for
Participating OASAS-
certified Facilities.

Outpatient Substance     N/A                          $20 Copayment                     30% Coinsurance after    Up to 20 visits
Use Services                                          0% Coinsurance                    Deductible               per Plan Year
(including Partial                                                                                               may be used
Hospitalization,                                                                                                 for family
Intensive Outpatient                                                                                             counseling
Program Services, and
Medication Assisted                                                                                              See benefit for
Treatment)                                                                                                       description

Except for Office
Visits,
Preauthorization
Required.
However,
Preauthorization is
not required for
Participating OASAS-
certified Facilities.

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NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

PRESCRIPTION DRUGS        Student Health Center         Participating Provider    Non-Participating      Limits
                          Member Responsibility         Member Responsibility     Provider Member
                          for Cost-Sharing              for Cost-Sharing          Responsibility for
                                                                                  Cost-Sharing
You may request a copy of the Wellfleet Rx/KPP Formulary. The Formulary is also available on the Wellfleet Rx website
at www.WellfleetRx.com. You may inquire if a specific drug is Covered under the Certificate by contacting Wellfleet
Student at the number on Your ID card, (877) 373-1170.
*Certain Prescription Drugs are not subject to Cost-Sharing when provided in accordance with the comprehensive
guidelines supported by HRSA or if the item or service has an “A” or “B” rating from the USPSTF
Retail Pharmacy
Supply Limits. Except for contraceptive drugs, devices, or products, We will pay for no more than a 30-day supply of a
Prescription Drug purchased at a retail pharmacy. You are responsible for one (1) Cost-Sharing amount for up to a 30-
day supply.

You may have the entire supply (of up to 12 months) of the contraceptive drug, device, or product dispensed at the
same time. Contraceptive drugs, devices, or products are not subject to Cost-Sharing when provided by a Participating
Pharmacy.

Please refer to Certificate of coverage for details.
30-day supply                                                                                                     See benefit for
                                                                                                                  description
Tier 1                    $10 Copayment                 $10 Copayment                     $10 Copayment
                          0% Coinsurance                0% Coinsurance                    0% Coinsurance not
                                                                                          subject to Deductible

Tier 2                    $25 Copayment                 $25 Copayment                     $25 Copayment
                          0% Coinsurance                0% Coinsurance                    0% Coinsurance not
If You have an                                                                            subject to Deductible
Emergency Condition,
Preauthorization is
not required for a five
(5) day emergency
supply of a Covered
Prescription Drug
used to treat a
substance use
disorder, including a
Prescription Drug to
manage opioid
withdrawal and/or
stabilization and for
opioid overdose
reversal.
Enteral Formulas                                                                                                  See benefit for
Tier 1                    $10 Copayment                 $10 Copayment                     $10 Copayment           description
                          0% Coinsurance                0% Coinsurance                    0% Coinsurance not
                                                                                          subject to Deductible

Tier 2                    $25 Copayment                 $25 Copayment                     $25 Copayment
                          0% Coinsurance                0% Coinsurance                    0% Coinsurance not
                                                                                          subject to Deductible

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NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

WELLNESS BENEFITS         Student Health Center        Participating Provider            Non-Participating
                          Member Responsibility        Member Responsibility             Provider Member
                          for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                         Cost-Sharing
Gym Reimbursement         N/A                          Up to $200 per six (6)            Up to $200 per six (6)    See Benefit
                                                       month period; up to an            month period; up to an    description
                                                       additional $100 per six           additional $100 per six
                                                       (6) month period for              (6) month period for
                                                       Covered Dependents                Covered Dependents

DENTAL and VISION         Student Health Center        Participating Provider            Non-Participating         Limits
CARE                      Member Responsibility        Member Responsibility             Provider Member
                          for Cost-Sharing             for Cost-Sharing                  Responsibility for
                                                                                         Cost-Sharing
Pediatric Dental Care

•   Preventive Dental     N/A                          $40 Copayment                     40% Coinsurance after
    Care                                               20% Coinsurance                   Deductible                One (1) dental
                                                                                                                   exam and
•   Routine Dental        N/A                          $40 Copayment                     40% Coinsurance after     cleaning per six
    Care                                               20% Coinsurance                   Deductible                (6)-month
                                                                                                                   period
•   Major Dental          N/A                          $40 Copayment                     40% Coinsurance after
    (Endodontics,                                      20% Coinsurance                   Deductible
    Periodontics, Oral
    Surgery and                                                                                                    Full mouth x-
    Prosthodontics)                                                                                                rays or
                                                                                                                   panoramic x-
•   Orthodontics          N/A                          $40 Copayment                     40% Coinsurance after     rays at 36
                                                       20% Coinsurance                   Deductible                month
Orthodontics and                                                                                                   intervals and
Major Dental Require                                                                                               bitewing x-rays
Preauthorization                                                                                                   at six (6)
                                                                                                                   month
                                                                                                                   intervals

Pediatric Vision Care

•   Exams                 Covered in full              $30 Copayment                     40% Coinsurance after     One (1) exam
                                                       20% Coinsurance                   Deductible                per Plan Year

•   Lenses and            $30 Copayment                $50 Copayment                     40% Coinsurance after     One (1)
    Frames                20% Coinsurance              20% Coinsurance                   Deductible                prescribed
                                                                                                                   lenses and
•   Contact Lenses        $30 Copayment                $50 Copayment                     40% Coinsurance after     frames per
                          20% Coinsurance              20% Coinsurance                   Deductible                Plan Year
Contact Lenses
Require
Preauthorization

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NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

DENTAL and VISION           Student Health Center            Participating Provider             Non-Participating                Limits
CARE                        Member Responsibility            Member Responsibility              Provider Member
                            for Cost-Sharing                 for Cost-Sharing                   Responsibility for
                                                                                                Cost-Sharing
Adult Vision Care

•   Exams                   Covered in full                  $30 Copayment                      40% Coinsurance after            One (1) exam
                                                             20% Coinsurance                    Deductible                       per Plan Year

Contact Lenses
Require
Preauthorization

Emergency Medical           0% coinsurance of - Actual Cost                                                                      Unlimited
Evacuation                                                                                                                       Annual Limits
                                                                                                                                 Combined with
                                                                                                                                 Repatriation
                                                                                                                                 Benefit.

Repatriation of             0% coinsurance of - Actual Cost                                                                      Unlimited
Remains                                                                                                                          Annual Limits
                                                                                                                                 Combined with
                                                                                                                                 Medical
                                                                                                                                 Evacuation
                                                                                                                                 Benefit.

Accidental Death and        N/A                              N/A                                                N/A              $10,000
Dismemberment                                                                                                                    Annual and
Benefits                                                                                                                         Lifetime
                                                                                                                                 Maximum

       Accidental Death and Dismemberment
       If, as the result of a covered Accident, You sustain any of the following losses, We will pay the benefit shown. The
       loss must occur within 365 days of the Accident.
                                                                                                               Percentage of Maximum Amount
                 Loss of Life ........................................................................................................100%
                 Loss of hand ....................................................................................................... 50%
                 Loss of Foot ....................................................................................................... 50%
                 Loss of either one hand, one foot or sight of one eye ....................................... 50%
                 Loss of more than one of the above losses due to one Accident......................100%
       Accident means a sudden, unforeseeable external event which directly and from no other cause, results in loss of
       life, hand, foot or sight.
       Loss of hand or foot means the complete severance through or above the wrist or ankle joint. Loss of eye means
       the total permanent loss of sight in the eye. The maximum amount is the largest amount payable under this benefit
       for all losses resulting from any one Accident.

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NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

Preauthorization Procedure
Preauthorization is required before You receive certain Covered Services. You are responsible for requesting
Preauthorization for the in-network and out-of-network services listed in the Schedule of Benefits section of the
Certificate.

If You seek coverage for services that require Preauthorization, You must call Wellfleet Student at the number
indicated on Your NYU sponsored Tandon student health insurance ID card.

You must contact Wellfleet Student to request Preauthorization as follows:
 •     At least two (2) weeks prior to a planned admission or surgery when Your Provider recommends inpatient
       Hospitalization. If that is not possible, then as soon as reasonably possible during regular business hours
       prior to the admission.
 •     At least two (2) weeks prior to ambulatory surgery or any ambulatory care procedure when Your Provider
       recommends the surgery or procedure be performed in an ambulatory surgical unit of a Hospital or in an
       Ambulatory Surgical Center. If that is not possible, then as soon as reasonably possible during regular
       business hours prior to the surgery or procedure.

You must contact Wellfleet Student to provide notification as follows:
 •     If You are hospitalized in cases of an Emergency Condition, You must call Wellfleet Student within 48 hours
       after Your admission or as soon thereafter as reasonably possible.

After receiving a request for approval, Wellfleet Student will review the reasons for Your planned treatment and
determine if benefits are available. Criteria will be based on multiple sources which may include medical policy,
clinical guidelines, and pharmacy and therapeutic guidelines.

Student Health Insurance Plan Costs
Costs for Students

                                                          Coverage Period                                Cost
                  Annual                                   8/21/20 – 8/20/21                            $1,964
--------------------------------------------------------------------------------------------------------------------------------------------------------
                  Fall Term                                 8/21/20 – 1/8/21                            $759
--------------------------------------------------------------------------------------------------------------------------------------------------------
                  Spring/Summer Term                        1/9/21 – 8/20/21                            $1,205
--------------------------------------------------------------------------------------------------------------------------------------------------------
                  Summer Term                              5/14/21 – 8/20/21                            $533
               -------------------------------------------------------------------------------------------------
                                                                                                 -------------------------------------------------------

Costs for Dependent Coverage (Spouse/Domestic Partner/One or More Children)

                                                          Coverage Period                                Cost
                  Annual                                   8/21/20 – 8/20/21                            $1,964
--------------------------------------------------------------------------------------------------------------------------------------------------------
                  Fall Term                                 8/21/20 – 1/8/21                            $759
--------------------------------------------------------------------------------------------------------------------------------------------------------
                  Spring/Summer Term                        1/9/21 – 8/20/21                            $1,205
--------------------------------------------------------------------------------------------------------------------------------------------------------
                  Summer Term                              5/14/21 – 8/20/21                            $533

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NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

    Costs for Family Coverage (Student/Spouse/Domestic Partner/One or More Children)

                                                              Coverage Period                                Cost
                      Annual                                   8/21/20 – 8/20/21                            $1,964
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                      Fall Term                                 8/21/20 – 1/8/21                            $759
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                      Spring/Summer Term                        1/9/21 – 8/20/21                            $1,205
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                      Summer Term                              5/14/21 – 8/20/21                            $533

    Insurance Payment Options
    The NYU sponsored student health insurance plan is an annual policy for students enrolled in NYU sponsored plan.
    Students may choose from the following payment options:

    A. ANNUAL PAYMENT IN FULL at the time of fall registration, with no insurance charge at spring registration.
       • Student’s coverage will continue through August 20th, even if they are not registered for spring classes.
          (However, they will not have access to services at the SHC after January 8th for January graduates and after
          graduation for May graduates.)
       • Students cannot get a partial refund of the spring/summer portion of the annual insurance charge after the
          September 30th enrollment deadline.

    B.   TWO INSTALLMENT PAYMENT PLAN (default plan): The first payment is due at the time of fall registration and
         the second at spring registration. The spring insurance charge is higher than the fall charge because it includes
         payment for coverage over the summer months.
         • Students will be automatically enrolled in the plan and billed the spring/ summer health insurance charge
              if, and only if, they are registered for classes or maintaining matriculation for the spring semester.
         • Students who are not registered for classes or maintaining matriculation for the spring semester will have
              their insurance coverage end on January 8th.

    Insurance Cards
    Insurance ID Cards are available to each student in a variety of ways:

         •     An online insurance card can be obtained by going to the Wellfleet Student web site
               (www.wellfleetstudent.com/nyu). Click the link for “Online ID Card.”
         •     An email will be sent on September 1, 2020 to those students enrolled in the NYU sponsored student health
               insurance plan with instructions on how to obtain their electronic ID cards.

    We encourage You to carry Your NYU ID and insurance card at all times.

Enrolling in the Student Health Insurance Plan
    Eligibility
         Students are eligible to enroll in the NYU sponsored student health insurance plan if they are:
         •     registered for one or more credits in a degree-granting program at NYU
         •     maintaining matriculation (completing certain academic programs and not enrolled in classes)
         •     Students with F-1 or J-1 visa status

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NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

    •    post-doctoral research trainees/fellows, paid by NYU on stipends (code 542) or paid directly by external
         sponsors
    •    Dependents of an insured Students (Spouse/domestic partner and Children up until the end of the month
         in which the Child turns age 26)

Automatic Enrollment
Most students are automatically enrolled in and charged Premium for the NYU sponsored student health plan as
part of the course registration process. Students should see the Automatic Enrollment Guide to determine if they
will be automatically enrolled.

Students who maintain alternate health insurance coverage that meets the University’s minimum health insurance
criteria may apply to waive the Student Health Insurance Plan entirely (see Waiving the Student Health Insurance
Plan section).

Please note: Adding or dropping courses during the registration period may affect a student’s automatic enrollment
in the NYU sponsored student health insurance plan. In such situations, confirm Your enrollment status before the
appropriate semester deadline (see Enrollment Deadlines section) to ensure Your coverage.

For students eligible for Graduate Employee NYU/UAW Local 2110, please see Graduate Employee NYU/UAW Local
2110 section.

Voluntary Enrollment
Students registered for classes or maintaining matriculation but not automatically enrolled, have the option to enroll
in the NYU sponsored student health insurance plan before the appropriate semester deadline (see Enrollment
Deadlines section) by completing the online enrollment process at www.nyu.edu/health/insurance (See Automatic
Enrollment Guide).

If You are on a school sanctioned leave: click here for NYU's policy.

Dependents
Eligibility
Eligible Dependents are:
     a) the covered Student’s Spouse or domestic partner; and/or
     b) the covered Student’s Child under the age of 26 years.

How to Enroll
To enroll eligible Dependents, insured Students must complete the online enrollment application and make payment
at www.wellfleetstudent.com/nyu by clicking on the Dependent Enrollment link from the menu on the left side of
the webpage by the appropriate deadline (see Enrollment Deadlines section). Dependent enrollment will be
available from 8/1 - 9/30.

Payment Options (Please see Costs section for costs.)
Students enrolling Dependents in the NYU sponsored student health insurance plan before the September 30th fall
term deadline may choose an annual payment option or an installment payment option. For students choosing the
installment payment option:
    •    The fall payment is due at the time of the fall enrollment.
    •    The spring payment is due by January 8th for the Dependent coverage to continue until August 20, 2021
         (the end of the Plan Year). Students will receive a 30-day notice before their fall coverage ends with a
         request for payment for the spring term coverage.

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                                 Wellfleet Student PO Box 15369 Springfield, MA 01115-5369
NEW YORK UNIVERSITY • TANDON SCHOOL OF ENGINEERING • 2020 - 2021 STUDENT HEALTH INSURANCE PLAN

Effective Dates of Coverage

                     Annual 2020-2021                                      August 21, 2020 - August 20, 2021
                           Fall 2020                                       August 21, 2020 - January 8, 2021
                   Spring/Summer 2021                                      January 9, 2021 - August 20, 2021
                        Summer 2021                                          May 14, 2021- August 20, 2021

How to Enroll
Students should evaluate their options by reviewing the benefits and exclusions of the NYU sponsored student health
insurance plan. Students should have their student ID number (shown on the admissions letter or on the back of the
NYU ID card) handy before accessing the online system during the enrollment periods.

•    Go to www.nyu.edu/health/insurance
•    Click on the box that indicates, “Enroll in or Waive out.” Read the general information and follow the
     instructions for enrolling.
•    At the end of the process, You must confirm Your enrollment selection in order for Your request to be
     processed.
•    Print the Confirmation of Status letter. A confirmation will also be sent to the e-mail address provided.

Enrollment Deadlines

If Your first semester of                          The online enrollment                                The SEMESTER DEADLINE for
the academic year is:                            system becomes available:                               enrolling in the NYU Plans is:

   Fall 2020                                                     June 16                                             September 30
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   Spring 2021                                                November 3                                              February 10
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   Summer 2021                                                    April 6                                                 June 5
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Important Enrollment Rules for Matriculated Students
     •     If the online enrollment process is not completed by the deadline, the plan in which the student is
           automatically enrolled will be in effect for all or any remaining part of the academic year.
     •     Students who were only billed the fall semester health insurance charge at the time of fall registration:
                o will be automatically enrolled in the plan and billed the spring/summer health insurance charge if,
                    and only if, they are registered for classes or maintaining matriculation for the spring semester.
                o will have their insurance coverage end on January 8th if they are not registered for classes or
                    maintaining matriculation for the spring semester.
     •     Students who paid the annual health insurance charge at the time of fall registration:
                o will continue coverage through August 20th, even if they are not registered or matriculated for
                    spring classes. (However, they will not have access to services at the SHC after January 8th for
                    January graduates and after graduation for May graduates.)
                o cannot get a partial refund of the spring/summer portion of the annual insurance charge after the
                    September 30th enrollment deadline.

                                                                                                                                                     26
                                          Wellfleet Student PO Box 15369 Springfield, MA 01115-5369
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