LSU Baton Rouge - FAQ’S

1. Am I required to enroll in the LSU Student Insurance Plan?

Domestic Students: The LSU Student Insurance Plan is a voluntary program for domestic students.

International Students: Students who are attending LSU on an F or J visa are automatically charged each semester for the Basic Plan on their student fee bill unless they receive a waiver by providing proof of alternate acceptable insurance coverage to the International Student Office (ISO) prior to the semester's deadline.

Non-Immigrant International Students enrolled in credit hours will be billed each semester(for the Basic Plan only) unless proof of other insurance is presented and a waiver granted.

Everyone including students. Good health is essential to your academic success, and adequate insurance enables you to get the care you need to maintain good physical and financial health. Unexpected medical bills can threaten your ability to complete your education if you are uninsured or have inadequate coverage.

1. Domestic Students: Domestic students may enroll through PAWS (under the "additional services" selections) until the 14th day of class each semester in order to begin coverage on the first available effective day fur the semester. Students may elect to purchase coverage for themselves and dependents directly from Macori at www.LSUstudentinsurance.com, by completing the enrollment process or printing and mailing the enrollment form with premium to the company. All dependent premiums, 3-pay and 9-pay plans must be purchased directly from Macori.
2. International Students: Students attending LSU on an F or J visa are automatically charged for the Basic Plan each semester unless an acceptable waiver is received by the International Services Office (ISO) prior to the semester's deadline. Dependent premium may be charged to the student's account by contacting the International Services Office (ISO) during registration. International students may only elect annual or semester payments. Students on an LSU student F visa have the option to purchase the Standard or Enhanced Plan.

The Master Policy on file at the University becomes effective at 12:01 a.m., August 14,2011. Coverage becomes effective on the first day of the period for which premium is paid or the date the enrollment form and full premium are received by the company (or its authorized representative), whichever is later. Students have a 31 day grace period each coverage period in which to pay the premium. Payments made during this grace period will become effective on the first day of the coverage period.

The Master Policy terminates at 12:00 midnight on August 13, 2012. An individual's coverage will terminate on that date, or at the end of the coverage period for which premium was paid, if earlier.

1. An eligible student may cover their dependents.
2. Domestic students may enroll their dependents online at www.LSUstudentinsurance.com by completing the interactive enrollment process or priting and mailing the enrollment form with applicable premium.
3. International students may add dependents to their account by completing arequest with the International Services Office (ISO) located in 101 Hatcher Hall. The premium will be added to the international student's account.

The 2011-2012 Policy Number is CHH0017842.

Your LSU Student ID number.

• Temporary ID cards may be printed 24/7/365 at www.LSUstudentinsurance.com.
• Permanent ID cards will be mailed to the address on file at LSU for the student.ID cards that are returned undeliverable will be sent to the Student Health Center for pickup. Please direct any ID Card questions to Macori, Inc. Premium and Enrollment Department by phone at 800-285-8133 or via email at Macori@macori.com.
• In the case of a lost card or prior to the weekly mailing dates, participants can print temporary ID cards at www.LSUstudentinsurance.com.

Contact Macori Administration directly by calling toll free at 800-285-8133, or via email at Macori@macori.com.

The Claims Notification Form is located in the "Brochure" section of the website.

A claim must be received by the Claims Office within 90 days from the date of service.

A claim must include:

1. The itemized medical and/or hospital bills,
2. Name of Patient,
3. Insured Student's name, address and LSU ID number,
4. A company form is requred for all claim forms, which can be completed online at www.LSUstudentinsurance.com or a PDF of the claim form is available to submit by mail.
5. Students Only - Student Health Center referral is required for ALL outpatient treatment except for medical emergencies or as stated in teh "Student Health Center (SHC) Referrals" section on page 6 of the Student Health Insurance Plan Brochure.

Macori, Inc. provides a dedicated service team for LSU. Participants may contact the dedicated service team directly by calling 800-285-8133. Participants also have access to view their enrollment information and Explanation of Benefits (EOB) online at www.LSUstudentinsurance.com.

No. The United States does not provide socialized medicine.

Students must use the resources of the LSU Student Health Center first, where treatment will be administered or a referral issued. Expenses incurred for medical treatment rendered outside the Student Health Center, for which no prior referral was obtained or for which the Student Health Center could have provided services will not be paid. Exceptions detailing when a student may use a provider outside the Student Health Center without a referral is listed below:

1. Medical emergencies. If follow-up care is needed, the student must return to the Student Health Center (see "Emergency" on page 13 of the Plan Summary).
2. When service is rendered at another facility during break or vacation periods. If follow-up care is needed, the student must return to the Student Health Center.
3. Medical care received when the student is more than 25 miles from campus. If follow-up care is needed, the student must return to the Student Health Center.
4. Medical care is obtained when a student is no longer able to use the SHC due to a change in student status. Proof of change in status must be submitted with claim.
5. Maternity.
6. Dependent spouses may utilize the Student Health Center; however, the referral requirement does not apply to to dependents.

Dependent children are not eligible to use the SHC; therefore they are exempt from the Student Health Center referral requirement.

Students are required to have pre-certification for outpatient surgery, inpatient, therapies, durable medical and inpatient mental health/substance abuse. Certifications must be made within 48 hours prior to hospitalization, outpatient surgical procedure, or upon diagnosis of pregnancy. If a hospital admission or outpatient surgical procedure is due to an emergency, certification must be received within 48 hours of the admisstion or procedure or as soon as possible. Failure to obtain pre-certification will result in all benefits being paid as non-network regarless if the provider is a network provider.

A "deductible" is the amount of money you must pay toward a medical bill before benefits are payable under the Plan.

A "copayment" is a specific out-of-pocket dollar amount which you must pay to a provider at the time of service. "Coinsurance" is a percentage of covered expenses which you must pay.

An "Exclusion" is a service that is not covered under your Plan. A "Pre-existing condition" is a medical condition for which a person has received a diagnosis, prescription medication, has been treated or was advised by a doctor to seek treatment within 90 days prior to initial enrollment in the policy, except for those Covered Persons who have been continuously insured under the LSU student insurance policy for 12 consecutive months of who have provided written proof of acceptable portability per the federal HIPAA guidelines.

Insureds will have one (1) year from the date of the Explanation of Benefits (EOB) to make an appeal to the Claims Office.

The appeal must be in writing and include:

• The claim information in question,
• A statement of why the claimant feels the denial or reduced payment was improper,
• The name of the health care provider or hospital;
• The date of service,
• The place of service,
• A description of the service,
• The charge.

A written response will be sent to the Insured. If the appeal involves a medical or legal issue, consultation may be obtained through Peer Review and/or Legal.

BIN # 005947 Group CATRX