Dartmouth College Health Service
5-7 Rope Ferry Road, HB 6143
Hanover, NH 03755
Phone: 603/646-9400
Fax: 603/646-9410
Dartmouth Student Group Health Plan
(DSGHP)
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| Click Image To Open Brochure |
2013 - 2014 Insurance Requirement and Waiver Process
Dartmouth college requires all students who are classified as active 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 completing the on-line insurance waiver petition.
DSGHP Annual Mailings:
Incoming Students:
- Undergraduates: Will be mailed via postal mail to the permanent address listed in Banner.
- Graduates: Will be mailed via e-mail to the e-mail address provided on the student's Dartmouth application from Dartmouth.Student.Health.Plan@Dartmouth.edu.
Returning Students:
- Undergraduates: Will be mailed via postal mail to the permanent address listed in Banner.
- Graduates: Will be mailed via e-mail to the student's college e-mail address from Dartmouth.Student.Health.Plan@Dartmouth.edu.
Click here for the 2013 - 2014 waiver requirements.
Accessing The On-line Waiver Petition Through Banner.
NOTE: Accessing the on-line waiver petition requires a username and password provided by the Admissions Office. You may not receive this information until the end of May/early June. Please make a note to complete the on-line waiver by July 1, 2013 if you want to waive the automatic DSGHP enrollment once you have received Banner access.
Late fees will be assessed for waivers completed after July 1, 2013.
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Approved waivers received between July 2, 2013 and July 31, 2013 will be subject to a $50.00 late fee.
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Approved waivers received after August 1, 2013 will be subject to a $100.00 per month late fee.
Once you have Banner access follow these steps for waiving DSGHP enrollment:
- Go to: http://www.dartmouth.edu/bannerstudent and enter your username and password.
- Go to your main Banner menu page and click on the "Health Center On-line Services" link and then click the "Insurance Enrollment" link. (You may need to temporarily allow pop-up blockers. Or, to bypass the pop-up blocker, hold down the 'Ctrl' key while you click on the link. If you receive a Security Certificate Notification, please click to continue through to the web page. This notification may appear on computers with newer security protocols, so not all will receive this message.)
- Proceed to the 'Insurance Enrollment' link on the left side of the page in the green bar. (Some Mac computers will not allow access to this page. If you are using a Mac and after following the above instructions are unable to access the page, you may need to try from a different computer.) Complete the on-line waiver using the step by step instructions provided above.
- Submit a front and back copy of your insurance identification card by postal mail to Waiver Processor, 7 Rope Ferry Road, HB# 6143, Hanover, NH 03755-1421, by fax to (603) 646-9410, or as an e-mail enclosure to Dartmouth.Student.Health.Plan@Dartmouth.EDU.
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.
2013-2014 DSGHP Coverage Information
Period Of Coverage (Plan Year)
- New First Time Students: August 1, 2013 - August 31, 2014
- Returning Students: September 1, 2013 - August 31, 2014
Coverage Fees (Dependent fees are in addition to the student fee)
- Student: $2,187.00
- One Dependent: $3,708.00 (plus $270.00 annual spouse/domestic partner health access fee if applicable)
- Two or More Dependents: $5,298.00 (plus $270.00 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 2013-2014 plan year is September 1, 2013. However, we strongly recommend that you submit a completed DSGHP dependent application by August 1, 2013 to insure that coverage will be activated and ready to use on September 1, 2013.
DSGHP Claim Forms
All forms and brochures require Acrobat Reader.
Contact Us
- Phone: 603/646-9438
- Fax: 603/646-9410
- E-mail: Dartmouth.Student.Health.Plan@dartmouth.edu
- Hours:
- Fall, Winter and Spring Terms: Monday - Friday, 8:00 AM - 4:30 PM; Closed from 12:00 PM - 1:00 PM
- Summer Term and Breaks: Monday - Friday, 8:00 AM - 4:00 PM; Closed 12:00 PM - 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.)
