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Dartmouth Student Group Health Plan
(DSGHP)

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• Facts About DSGHP
• DSGHP Advisory Committee
• Medco and Klais Claims

 

2012 - 2013 Insurance Requirement and Waiver Process

Dartmouth college requires all students who are classified as full-time in the College Student Information System (Banner), including students not taking classes or on a leave term, to have health insurance meeting specified standards of coverage.  Eligible students are automatically enrolled in the Dartmouth Student Group Health Plan (DSGHP) each academic year and the cost of the plan is billed to their tuition account.  Students who have insurance coverage that meets Dartmouth's insurance requirements may apply to waive the automatic enrollment into the DSGHP by submitting a completed insurance waiver petition. 

Important 2012 - 2013 information and deadlines that you should know.

DSGHP Enrollment / Insurance Waiver Requirements:

• Scheduled to be mailed to the student at their permanent address late May 2012 or early June 2012.
• If waiving out of DSGHP, the deadline for receipt of your completed insurance waiver petition is July 2, 2012.  Late fees will be assessed for waivers received after July 2, 2012.

Check back with us in late May for further waiver instructions and links.

 

 

2011-2012 Insurance Requirement and Waiver Process

Dartmouth College requires all students who are classified as full-time in the College Student Information System (Banner), including students not taking classes or on a leave term, to have health insurance meeting specified standards of coverage. Therefore, all full-time Dartmouth students are automatically enrolled in the Dartmouth Student Group Health Plan (DSGHP) each year they are eligible with the cost of the plan being charged to their student account. 

Students who have insurance coverage that meets Dartmouth's insurance requirements may apply to waive the automatic enrollment into the DSGHP by submitting a completed waiver petition.  A new completed waiver petition needs to be submitted each academic year and approved 2011 - 2012 waivers will be valid through August 31, 2012. 

Click here for the 2011 - 2012 waiver requirements.

• 2011 - 2012 Paper Waiver Petition & Instructions
• 2011 - 2012 On-line Waiver Instructions 
• Mid Year Cancellation Application
• 2011 - 2012 DSGHP Mid Year Enrollment/Waiver Petition
• Take The Test (Compare your health plan coverage to DSGHP coverage)

Attention New Students:  Don't forget your required pre-matriculation health requirements! Available at http://www.dartmouth.edu/~health/resources/incoming/index.html. These need to be completed even if you waive DSGHP enrollment.

2011-2012 DSGHP Coverage Information

Period Of Coverage (Plan Year)

• New First Time Students:   August 1, 2011 - August 31, 2012
• Returning Students:          September 1, 2011 - August 31, 2012 

Coverage Fees (Dependent fees are in addition to the student fee)

• Student:   $1,948.00
• One Dependent:   $3,303.00 (plus $225.00 annual spouse/domestic partner health access fee if applicable)
• Two or More Dependents:   $4,719.00 (plus $225.00 annual spouse/domestic partner health access fee if applicable)

NOTE:  A new dependent application needs to be submitted each plan year, dependent re-enrollment is not automatic.  The deadline for enrolling dependents for the 2011-2012 plan year is September 1, 2011. However, we strongly recommend that you submit a completed DSGHP dependent application by August 1, 2011 to insure that coverage will be activated and ready to use on September 1, 2011. 

• Dependent Application
• 2011 - 2012 DSGHP Plan Document 
• 2011 - 2012 DSGHP Mid Year Enrollment/Waiver Petition

DSGHP Claim Forms

All forms and brochures require Acrobat Reader.

• DSGHP Medical Claim Form
• DSGHP Prescription Claim Form
• DSGHP Coordination of Benefits Prescription Claim Form

 

Contact Us

• Phone: 603/646-9438
• Fax:  603/646-9450
• E-mail: Dartmouth.Student.Health.Plan@dartmouth.edu
• Hours: Monday - Friday, 8:00 AM - 4:30 PM; Closed from 12:00 noon - 1:00 PM
• Location: Room 111 of 5 Rope Ferry Road, Hanover NH 03755
• Campus Address: HB 6143

 

Health Plan Coverage For Dartmouth Students

The DSGHP benefit program is designed to complement services available through the Dartmouth College Health Service. Spouses and domestic partners covered in the DSGHP Family Plan may use the Primary Care services at Dick's House.

Some features of the Dartmouth Student Group Health Plan, which may not be in your insurance plan, include:

• Coordination of services by Health Service staff who know Dartmouth students
• Coverage for injuries sustained in Intercollegiate or club sports
• Family plan coverage for students with dependents
• First Dollar Benefits for eligible Health Service expenses
• Major Medical Benefits for hospitalization and physician services
• Prescription Drug Benefits on campus and nationally through the Medco Health Network
• Preferred Provider Network includes the Dartmouth-Hitchcock Medical Center
• No Waiting Period or Pre-existing Condition exclusions
• On Campus Assistance with enrollment and claim submission
• Special Outpatient mental health benefits
• World-wide coverage

(This brief summary does not constitute a promise of benefits on behalf of the Plan or Dartmouth College. Please see the Plan Document for a complete description of benefits, limitations, exclusions and special provisions.)