Skip to main content
Sign In
 

Plan Benefits & Forms


Plan Benefits

For the full benefits and coverage please see the plan certificate. This certificate of coverage provides details of the coverage including cost, benefits, exclusions, reductions or limitations, and the terms under which the coverage may be continued in force. A plan summary is also available. If you have questions please contact United Healthcare Student Resources Customer Service at 1-800-767-0700 or at customerservice@uhcsr.com.

Here are some Preferred In-Network Provider costs for the 2019/20 plan year:

  • Plan Deductible = $250
  • Copay for a Physician’s Visit = $25
  • Copay for an Urgent Care Visit = $35
  • Copay for Emergency Room care = $200

*Disclaimer: The master policy on file at the university contains all the provisions, limitations, exclusions, and qualifications of the plans, which may not be included on the web pages. The master policy is the contract and will govern and control the payment of benefits.

The information on this website is intended to provide guidance to the benefits of the insurance and how to utilize its services. It in no way constitutes a guarantee of payment for claims submitted to the insurance company.


Forms

OPT Enrollment Form - Students in Optional Practical Training (OPT) are eligible to purchase the student health insurance plan on a voluntary basis as long as they have a valid student visa.

ESL Enrollment Form - English Speaking Language (ESL) students are eligible to purchase the student health insurance plan on a voluntary basis as long as they have a valid student visa.

Dependent Enrollment Form - Students may enroll their eligible family members as dependents during the enrollment period.

Qualifying Life Event Dependent Enrollment - Students that experience a Qualifying Life Event after the enrollment period may enroll their eligible family members as dependents.

Global Travel Plus​ - Visit Global Travel Plus for the American College Student Association to enroll and purchase the Medical Evacuation & Repatriation (MER) coverage.


© The Regents of the University of Colorado, a body corporate. All rights reserved.

Accredited by the Higher Learning Commission. All trademarks are registered property of the University. Used by permission only.