Health Insurance FAQs

Health Insurance FAQ's 2012

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Common questions about Student Health Insurance

Why is health insurance necessary as a college student?

When preparing for college, no student plans to become seriously ill or injured. High health care costs can be a challenging obstacle, especially for students. Health insurance is purchased to protect against the risk of incurring high medical expenses. Student may need to stop or defer their education due to financial hardships.  

What is a “hard waiver”?

Wheaton College practices a “hard waiver” insurance program. This simply means that every student is required to show proof of health insurance annually. All special students taking nine or more credit hours and degree seeking students are automatically enrolled and billed a six month premium to their student accounts for the Wheaton College Student Health Insurance Plan (SHIP) until they provide a completed online waiver form. Wheaton College has created guidelines of what comparable health insurance coverage is. You can view those SHI Requirements

Why do I need to show proof of health insurance every year?

Most health insurance plans work on an annual basis.  Every year the insurance company re evaluates what type of service and premium price they are giving to the client.  Clients are also able at that time to end their relationship with the insurance company or ask to continue. Health insurance is changing constantly and the needs of students are also changing.  For incoming fall students, beginning mid June until mid September Wheaton College provides an “open enrollment” time for students to leave the program or re enter the program with no questions asked.  All new and continuing students will need to provide proof of comparable health insurance coverage during this “open enrollment” period.  If no comparable coverage in the form of a waiver is received from the student to Gallagher Koster by the deadline, the student will be enrolled in the program with no ability to waive out until the next semester. To access the online waiver, go to the GallagherKoster website .

What do I need to do to remove the charge for health insurance on my student account?

If you have other health insurance that meets the Wheaton College requirements, an online waiver may be submitted before the stated deadline to reverse the charge. Please refer to the Health Insurance section of the website for additional information.

Can I use SHS services and the medical shuttle even if I do not have the Student Health Insurance Program?

YES! The services of the Wheaton College SHS are available to all students regardless of your health insurance coverage. 

What is the “Student Health Insurance Program” (SHIP)?

Wheaton College requires for all students to be insured. Consequently, the College offers a Student Health Insurance Plan through Gallagher Koster that provides worldwide coverage to help cover the costs of treatment for an injury or sickness and many preventive medical needs. If you are an active student that does not have a comparable coverage health insurance plan or is currently uninsured, you could qualify for this plan. To learn more about Gallagher Koster and the health insurance plan go to the GallagherKoster website

To see if you are eligible, go to Insurance Info Requirements.

Who do I contact about a health insurance question?

Call the 1-800 number on the back of your health insurance card if you have your own or your parent's insurance.

If you have the Student Health Insurance Plan, you can contact Gallagher Koster directly with any questions relating to how to waive out of SHIP and what the benefits of the SHIP plan are?  They can be reached at 855-275-3700 or by e-mail .  Wheaton College is an academic institution and does not manage or administer the health insurance program. 

Do I need to pay for medical services at Student Health Services (SHS) at the time of service?

Many of the services that SHS provides to students are free of cost. While several services in SHS are free of charge, some also have fees. All fees incurred at SHS are billed to the student’s account, and any bills payable should be remitted to the Student Accounts office (630-752-5801). You will receive a statement for these services in your CPO box. The statement received in your CPO is for submission to your health insurance company for possible reimbursement. Student Health Services does not bill insurance companies directly. Your balance at Student Accounts is due by the due date, regardless of reimbursement status.

If I have the SHIP and have seen a medical provider in the community, how do I get that visit paid for?

If you are part of the Gallagher Koster student health insurance plan, you will be provided with an insurance card that may come to your CPO box. You must provide this insurance card at any doctor’s office or pharmacy at the time of service or requesting an appointment.  These offices will send their bills to the insurance claims company for reimbursement.  You may need to pay for some services at the time of service. You may also receive a bill for any left over charges that the insurance company does not cover.

If I use SHS how do I get that visit paid for?

SHS is a preferred provider within the SHIP. A preferred provider or “in network” provider means that the insurance company covers a greater percentage of the cost within  these medical offices than “out of network” providers.  If you have used a billable services at SHS, you will be sent a statement in your CPO box with a claim form. Fill out this claim form and send it into the claims company, Klais Claims. If you are due any reimbursement, they will provide this to you directly. You can use this reimbursement to pay your student account charge.

Questions about a specific claim or claims payment?

Klais & Company, Inc.
1867 West Market Street
Akron, OH 44313
1-877-349-9017
Email: Klaisclaims@klais.com
www.Klais.com

What is the difference between Gallagher Koster and Klais claims company?

Gallagher Koster is a company that assists Wheaton College in providing health insurance that is helpful to the type of students that Wheaton College has. They are also the company that assists with answering any questions you might have about the insurance plan or the waiver. Klais is the company that pays the health bills that you have incurred.  There is more information about Klais Claims at the GallagherKoster website.

 If you have questions about your bill, you will need to contact Klais at 877-349-9017, or contact them by email .  If you need another claim form for services that you have incurred at Student Health Services you can download one >>.

What is an “in network” provider?

Insurance companies select certain medical practices or physicians that they place in a group or network.  If a patient should use this selected practice or group, the patient will receive a higher percentage of reimbursement and therefore a lower price to pay.  If you have the SHIP, you can find which medical service, physician or hospital in the network by using the on line search module. Private Healthcare System (PHCS) is the network that the SHIP uses. You can go to their website to find a preferred provider.  You can also call PHCS at 1-800-922-4362. SHS is part of this network.  All covered services at SHS are covered 100% if you have the SHIP.

How can I find a Participating Pharmacy?

Express Scripts
Website: www.gallagherkoster.com/WheatonIL, click on ‘Pharmacy Program’
Phone: 1-800-892-5119

How do I learn more about Worldwide Assistance Services?

Travel Assistance Services and 24-Hour Nurse Advice Line
On Call International
Toll Free from U.S. and Canada: 1-800-850-4556
Dial Direct or Call Collect Worldwide: 1-603-898-9159
www.oncallinternational.com

Do I get an ID Card?

Yes, ID Cards are made available online 24-48 hours upon enrollment in the plan. ID Cards are also mailed to the address the school has on file for you and can be printed per the request of the school or student.

How do I print an ID card online?

  1. www.gallagherkoster.com/WheatonIL
  2. Log-in using your existing account information (first time visitors will need to create an account).
  3. Select “Authorize Account” located to the left of your screen under Account Information and entered your Student ID number along with your date of birth.
  4. Once your account has been authorized, select "Account Home" and click on "Generate ID Card".

 

How can I learn more about the Student Health Insurance?

The GallagherKoster website has a page that contains three other links >> to tell you more about the cost, benefits and other FAQ’s that you might have.

Why is health insurance necessary as a college student?

When preparing for college, no student plans to become seriously ill or injured. High health care costs can be a challenging obstacle, especially for students. Health insurance is purchased to protect against the risk of incurring high medical expenses. Student may need to stop or defer their education due to financial hardships.  

What is a “hard waiver”?

Wheaton College practices a “hard waiver” insurance program. This simply means that every student is required to show proof of health insurance annually. All special students taking nine or more credit hours and degree seeking students are automatically enrolled and billed a six month premium to their student accounts for the Wheaton College Student Health Insurance Plan (SHIP) until they provide a completed online waiver form. Wheaton College has created guidelines of what comparable health insurance coverage is. You can view those SHI Requirements

Why do I need to show proof of health insurance every year?

Most health insurance plans work on an annual basis.  Every year the insurance company re evaluates what type of service and premium price they are giving to the client.  Clients are also able at that time to end their relationship with the insurance company or ask to continue. Health insurance is changing constantly and the needs of students are also changing.  For incoming fall students, beginning mid June until mid September Wheaton College provides an “open enrollment” time for students to leave the program or re enter the program with no questions asked.  All new and continuing students will need to provide proof of comparable health insurance coverage during this “open enrollment” period.  If no comparable coverage in the form of a waiver is received from the student to Gallagher Koster by the deadline, the student will be enrolled in the program with no ability to waive out until the next semester. To access the online waiver, go to the GallagherKoster website .

What do I need to do to remove the charge for health insurance on my student account?

If you have other health insurance that meets the Wheaton College requirements, an online waiver may be submitted before the stated deadline to reverse the charge. Please refer to the Health Insurance section of the website for additional information.

Can I use SHS services and the medical shuttle even if I do not have the Student Health Insurance Program?

YES! The services of the Wheaton College SHS are available to all students regardless of your health insurance coverage. 

What is the “Student Health Insurance Program” (SHIP)?

Wheaton College requires for all students to be insured. Consequently, the College offers a Student Health Insurance Plan through Gallagher Koster that provides worldwide coverage to help cover the costs of treatment for an injury or sickness and many preventive medical needs. If you are an active student that does not have a comparable coverage health insurance plan or is currently uninsured, you could qualify for this plan. To learn more about Gallagher Koster and the health insurance plan go to the GallagherKoster website

To see if you are eligible, go to Insurance Info Requirements.

Who do I contact about a health insurance question?

Call the 1-800 number on the back of your health insurance card if you have your own or your parent's insurance.

If you have the Student Health Insurance Plan, you can contact Gallagher Koster directly with any questions relating to how to waive out of SHIP and what the benefits of the SHIP plan are?  They can be reached at 855-275-3700 or by e-mail .  Wheaton College is an academic institution and does not manage or administer the health insurance program. 

Do I need to pay for medical services at Student Health Services (SHS) at the time of service?

Many of the services that SHS provides to students are free of cost. While several services in SHS are free of charge, some also have fees. All fees incurred at SHS are billed to the student’s account, and any bills payable should be remitted to the Student Accounts office (630-752-5801). You will receive a statement for these services in your CPO box. The statement received in your CPO is for submission to your health insurance company for possible reimbursement. Student Health Services does not bill insurance companies directly. Your balance at Student Accounts is due by the due date, regardless of reimbursement status.

If I have the SHIP and have seen a medical provider in the community, how do I get that visit paid for?

If you are part of the Gallagher Koster student health insurance plan, you will be provided with an insurance card that may come to your CPO box. You must provide this insurance card at any doctor’s office or pharmacy at the time of service or requesting an appointment.  These offices will send their bills to the insurance claims company for reimbursement.  You may need to pay for some services at the time of service. You may also receive a bill for any left over charges that the insurance company does not cover.

If I use SHS how do I get that visit paid for?

SHS is a preferred provider within the SHIP. A preferred provider or “in network” provider means that the insurance company covers a greater percentage of the cost within  these medical offices than “out of network” providers.  If you have used a billable services at SHS, you will be sent a statement in your CPO box with a claim form. Fill out this claim form and send it into the claims company, Klais Claims. If you are due any reimbursement, they will provide this to you directly. You can use this reimbursement to pay your student account charge.

Questions about a specific claim or claims payment?

Klais & Company, Inc.
1867 West Market Street
Akron, OH 44313
1-877-349-9017
Email: Klaisclaims@klais.com
www.Klais.com

What is the difference between Gallagher Koster and Klais claims company?

Gallagher Koster is a company that assists Wheaton College in providing health insurance that is helpful to the type of students that Wheaton College has. They are also the company that assists with answering any questions you might have about the insurance plan or the waiver. Klais is the company that pays the health bills that you have incurred.  There is more information about Klais Claims at the GallagherKoster website.

 If you have questions about your bill, you will need to contact Klais at 877-349-9017, or contact them by email .  If you need another claim form for services that you have incurred at Student Health Services you can download one >>.

What is an “in network” provider?

Insurance companies select certain medical practices or physicians that they place in a group or network.  If a patient should use this selected practice or group, the patient will receive a higher percentage of reimbursement and therefore a lower price to pay.  If you have the SHIP, you can find which medical service, physician or hospital in the network by using the on line search module. Private Healthcare System (PHCS) is the network that the SHIP uses. You can go to their website to find a preferred provider.  You can also call PHCS at 1-800-922-4362. SHS is part of this network.  All covered services at SHS are covered 100% if you have the SHIP.

How can I find a Participating Pharmacy?

Express Scripts
Website: www.gallagherkoster.com/WheatonIL, click on ‘Pharmacy Program’
Phone: 1-800-892-5119

How do I learn more about Worldwide Assistance Services?

Travel Assistance Services and 24-Hour Nurse Advice Line
On Call International
Toll Free from U.S. and Canada: 1-800-850-4556
Dial Direct or Call Collect Worldwide: 1-603-898-9159
www.oncallinternational.com

Do I get an ID Card?

Yes, ID Cards are made available online 24-48 hours upon enrollment in the plan. ID Cards are also mailed to the address the school has on file for you and can be printed per the request of the school or student.

How do I print an ID card online?

  1. www.gallagherkoster.com/WheatonIL
  2. Log-in using your existing account information (first time visitors will need to create an account).
  3. Select “Authorize Account” located to the left of your screen under Account Information and entered your Student ID number along with your date of birth.
  4. Once your account has been authorized, select "Account Home" and click on "Generate ID Card".

 

How can I learn more about the Student Health Insurance?

The GallagherKoster website has a page that contains three other links >> to tell you more about the cost, benefits and other FAQ’s that you might have.