The following charts show how the UNL "Healthy Option" insurance plan pays for benefits for the major types of expenses. You can see the difference in your cost when you use preferred providers. Plan year is from August 14, 2007 to August 13, 2008.

Summary of Medical Benefits
Aggregate Maximum	$250,000 per Policy Year
Deductible	Covered medical expenses incurred at the UHC will be payable at 100% with waiver of the Policy Year Deductible.
Coinsurance	Preferred Care 80% of the Negotiated Charge for the first $9,750 of Covered Medical Expenses; 100% thereafter.	Non-Preferred Care 60% of the Reasonable Charge for the first $4,875 of Covered Medical Expenses, 100% thereafter.*
Please Note: The coinsurance reimbursement levels indicated above apply to treatment received outside the UHC and are not payable until the $400 Policy Year Deductible has been satisfied.
Coinsurance Maximum - $1,950 per insured, per Policy Year. (This coinsurance maximum does not include the $400 Policy Year Deductible.) *Your total out-of-pocket expenses may exceed the Coinsurance Maximum (plus Deductible) if you receive care from non-preferred providers.
Co-Pay - In addition to the Policy Year Deductible and Coinsurance Maximum, each insured person will be responsible for a $100 per emergency room visit co-pay amount and a $250 per inpatient admission co-pay amount. The co-pay normally does not apply to urgent care center charges.

Summary of Dental Benefits
*When receiving a Preventive procedure from a dentist who is not a University Health Center Dental Office provider, the coinsurance is 80% of the Maximum Allowable Benefit. The Maximum Allowable Benefit is the amount that University Health Center dentists have agreed to charge plan members for services.
Coinsurance (Plan Pays)	UHC Dental Office	All Other Providers
Preventative Procedures	100%	80% *
Basic Procedures	Payment Schedule	Payment Schedule
	Deductible Amounts
Preventative Procedures	$0
Basic Procedures (Each Plan Year)	$50 of allowable insurance payment
Preventative and Basic Procedures (Each Plan Year)		$75
Maximum Plan Year Benefits
Preventative and Basic Procedures (Per Person)	$500	$500
("Payment Schedule" means the Pre-Determined Allowance for each Covered Person)

Pharmacy Coverage

NEW! - A Pharmacy Program has been added to the UNL "Healthy Option" insurance plan package. It has a $500 benefit ($10 generic/$25 brand-name copays) available only at the UHC Pharmacy.

UNL "Healthy Option" Insurance Plan Enrollment - Getting Started

Who is Eligible for Coverage?

Your method of enrollment in the UNL "Healthy Option" insurance plan will depend on your course load and class status. PLEASE NOTE: All students enrolled for three or more credit hours at UNL and who have paid the Health Center Student Facility Fee, are eligible to purchase the plan. Unless a medical condition prohibits, students must actively attend class for at least the first 31 days after the date for which coverage is purchased. The three or more credit hour requirement does not apply to international students, graduate assistants, and masters and doctoral students enrolled in 1 or 2 credit hours for the purposes of completing thesis or dissertation graduation requirements.

How to Enroll

Chickering Benefit Planning Insurance Agency, Inc. processes enrollment for health and dental coverage. Health and dental insurance cannot be purchased separately.

You can enroll online by following these easy steps:

• Visit www.chickering.com
• Click on "Find Your School".
• Type in your school Policy Number 100102 or search by school name.
• Once at your school web page, click on the link entitled "Enroll Online for your Chickering Insurance Plan".

It will not be necessary for Graduate Assistants or International Students (F1 and J1 Visa) to complete the enrollment process - the University will automatically enroll these students. Dependents of Graduate Assistants and International Students, however, will be required to complete the enrollment process at: www.chickering.com.

Enrollment Forms are available if necessary at the University Health Center, 15th and U Streets.

Please note: It is the student's responsibility to renew the insurance coverage and to verify their effective and termination dates with Chickering Benefit Planning Insurance Agency, Inc., on each Policy anniversary.

Premium Rates
	Annual	Fall	Spring/Summer
Student	$1,052	$410	$643
Spouse/Domestic Partner	$3,410	$1,308	$2,104
Each Child	$1,713	$661	$1,054

Insurance Waiver Deadlines
International Students

This coverage is mandatory for International Students unless proof of comparable insurance coverage is presented, and a waiver is filed by the 14th day of classes. In the absence of a waiver, the insurance premium will be automatically placed on your Student Account Statement.

Graduate Assistants

Student insurance is provided as part of the University Graduate Assistant employment package. Non-participation in this program will require a completed waiver within 14 days of employment.

Questions? - How to Reach Us