School Coverage Periods & Rates

ANNUAL 2021-2022
30-DAY RATE

Maple J1

  • In-Network Provider - Aetna
  • No Lifetime Limits On Benefits
  • $100,000 per Injury/Illness
  • Coinsurance: 80% In-Network, 70% Out-Network
  • Physician Office Visit Copayment - $0
  • Urgent Care Center Copayment - $0
  • Diagnostic X-ray Services - 80% PA
  • Laboratory Procedures - 80% PA
  • Prescription Drug Benefits - 80% PA
  • Repatriation of Remains - $25,000
  • Medical Evacuation - $50,000
  • A.M. Best rating: A
  • COVID is treated like any other sickness

Oak J1

  • In-Network Provider - Aetna
  • No Lifetime Limits On Benefits
  • $100,000 per Injury/Illness
  • Coinsurance: 80% In-Network, 70% Out-Network
  • Physician Office Visit Copayment - $0
  • Urgent Care Center Copayment - $0
  • Diagnostic X-ray Services - 80% PA
  • Laboratory Procedures - 80% PA
  • Prescription Drug Benefits - 80% PA
  • Repatriation of Remains - $25,000
  • Medical Evacuation - $50,000
  • A.M. Best rating: A
  • COVID is treated like any other sickness

Cedar J1

  • In-Network Provider - Aetna
  • No Lifetime Limits On Benefits
  • $100,000 per Injury/Illness
  • Coinsurance: 100%
  • Physician Office Visit Copayment - $0
  • Urgent Care Center Copayment - $0
  • Diagnostic X-ray Services - 100% PA
  • Laboratory Procedures - 100% PA
  • Prescription Drug Benefits - 100% PA
  • Repatriation of Remains - $25,000
  • Medical Evacuation - $50,000
  • A.M. Best rating: A
  • COVID is treated like any other sickness

Claim Procedures

Step 1: Bring Your Insurance ID card

Login to your PSI account and print your Insurance ID Card. Always present your Insurance ID Card to your Doctor or Hospital so they can submit your claim directly to us.

Step 2: Visit your Student Health Center or a Preferred Provider

If you are sick or injured, please visit the Student Health Service first. If not available, proceed to a Preferred Provider Network.
We encourage students to use a Preferred Provider whenever possible for two reasons:

1) They have a contract to bill us directly for services so you don't have to pay out of pocket and then file a claim yourself;

2) They have agreed to contracted pricing for covered medical expense, which means your medical cost and charges are kept as low as possible and never exceed the set price which providers accept as payment.

If you visit an Out-of-Network Doctor or Hospital, ask if they can submit claims on your behalf. If they cannot, you will be required to pay for your medical bills during your visit. Afterwards, seek reimbursement by filing a claim. Simply download a Claim Form, Complete, and Sign then include a copy of your ID Card with your medical bills or receipts.

FAQs