2009 - 2010 DSGHP Waiver Requirements

Dartmouth College requires all active students, including students not taking classes or on a leave term, to have health insurance meeting specified standards of coverage. To this end, all active Dartmouth students are automatically enrolled in the DSGHP each September 1st, and the related fee is billed to their student account in August. To waive enrollment in the DSGHP, a student must submit a new, completed waiver petition each academic year. If a completed waiver application is received by August 1st, a student's enrollment in the DSGHP will be cancelled, and a credit will be given for the fee charged.

If you want to waive enrollment in the DSGHP because you already have health insurance coverage that meets the waiver conditions below, complete a 2009 - 2010 waiver petition and submit it to the address above by August 1st, 2009. After this deadline, enrollment in the DSGHP may not be waived except as provided in the Plan document, which can be found at www.dartmouth.edu/~health/depts/insurance/index.html. Approved waivers will be valid through August 31st, 2010.

All six conditions and the plan representative's signature must be provided at the start of each academic year for DSGHP enrollment to be waived.

1. The plan includes Dartmouth Hitchcock Medical Center (www.dhmc.org) and its affiliated physicians as in-network providers and/or provides in-network level benefits for both emergency and non-emergency health care services received in the Hanover, NH area. (Plans that provide only emergency coverage in the Hanover, NH area do not meet this requirement.)
2. The plan provides coverage for inpatient and outpatient mental health care and chemical/substance abuse treatment. Benefits include at least thirty (30) outpatient mental health visits in the Hanover, NH area.
3. The maximum benefit for the coverage is $500,000 or more per year.
4. The plan covers (i.e. there is no exclusion or limitation for participation in high-risk activities or sports) expenses incurred in the United States and abroad for participation in varsity intercollegiate sports (including practice sessions), club sports or intramural sports, and for participation in Dartmouth College sponsored or provided activities (e.g. Dartmouth Outing Club outdoor activities).
5. The plan will remain in force as long as the student remains active (including on an approved leave of absence, leave term, or pending graduation) for the plan year beginning September 1st, 2009 and ending August 31st, 2010.
6. The plan is licensed to do business in the United States of America (USA), has a USA-based claims processor, and a USA telephone number.

Click Here for the Dartmouth Student Group Health Plan waiver petition.