Waiver-Requirements-Checklist-RHODES-7-14-21

Waiver Requirements for Student Health Insurance Plan 2021-2022 Rhodes College is committed to student success and well-being To that end, all Undergraduate students enrolled in or more credits and all Graduate students enrolled in or more credits are required to be covered with personal health insurance If you elect to waive enrollment in the Student Health Insurance Plan for yourself (if permitted) we require that the alternative health coverage meets the following minimum criteria Foreign insurance, non- (state) HMO’s, and travel insurance plans are not acceptable as alternative coverage as they not meet the minimum requirements If your plan does not meet these minimum requirements, your waiver will be denied, and you will be enrolled and charged for the school sponsored plan To view more information about the Rhodes College Student Health Insurance Plan please go to www.firststudent.com Criteria Does your insurance provide coverage for the entire 20212022 academic year? My Plan Rhodes College meets the Student Health Insurance Plan criteria: (Yes or No)  Yes Effective date: 8/1/21  No Termination date: 7/31/22 I understand that if I lose coverage through no fault of my own during the school year, I am required to contact United Healthcare or to enroll in the school-sponsored Health Insurance plan or provide proof of enrollment in a comparable plan  Yes I have verified that my plan provides for both emergency  No health care and in-patient care including room & board, hospital services and surgeon fees in the Memphis, TN area I acknowledge that if my plan does not have participating emergency or in-patient care in the Memphis area, I am responsible for payment of all fees for medical treatment not covered by my health insurance plan