Columbia University Health Services

Period of Coverage for Eligible Dependents

Coverage will become effective on the same date the insured student's coverage becomes effective; if dependents are enrolled prior to the deadline, coverage begins September 1, 2009.

A new enrollment request for Dependent Coverage must be provided by September 30^th in each Plan Year. Covered students may also request enrollment of their dependents beginning with the Spring term if the request and applicable premiums are submitted by February 1. Unlike the student plan, dependents’ Fall Term enrollment is not automatically continued for the Spring Term. Dependents have the option to remain insured for the period from January 19, 2010 through August 31, 2010 by completing a new application form and submitting the Spring Term premium. The deadline for enrolling for the Spring Term is February 1, 2010. Previously insured dependents and students must re-enroll before the deadline in order to avoid a break in coverage for conditions that existed in prior Policy Years. Once a break in continuous coverage occurs, the definition of Pre-Existing Condition will apply in determining coverage of any condition that existed during the break.

Coverage for insured dependents terminates in accordance with the Termination provisions described in the Master Policy. Termination of benefits may be affected by the following factors, among others: the date the student's coverage terminates and the date the dependent no longer meets the definition of a dependent.

Enrollment of Eligible Dependents

Dependents are not automatically enrolled. Application forms for dependent enrollment are available online at the Aetna Student Health website.

A new application for dependent coverage must be submitted each term by the deadlines below:

Fall: *deadline for Fall 2009 has passed*
Spring: February 1, 2010

Newborn or Newly Adopted Children

Children born to a covered person during the Plan term will be covered for accident, sickness, and congenital defects for 31 days from the date of birth. At the end of this 31-day period, coverage will cease unless the newborn is enrolled in the Plan.

Coverage is also provided for a child legally placed for adoption with a covered person, for 31 days from the moment of placement, provided that the child lives in the household of the covered person and is dependent upon him or her for support. At the end of this 31-day period, coverage will cease unless the adopted child is enrolled in the Plan.

All benefits available for newborn and newly adopted children, within 31 days of birth or placement, are equal to those available for individuals covered under the Plan.

Benefits for Eligible Dependents

Coverage for dependents is provided in the same manner as for enrolled students, with the following exceptions:

• Policy Year Maximum: $300,000 per Accident or Sickness
• Physician's Office Expenses for Well-Baby Care (children age 19 and under) are covered in the same manner as Physicians Office Visits for enrolled students in the Basic Level of the Plan.
• Covered Medical Expenses for the administration of an immunization or a vaccine, as well as the cost of the immunization agent itself, are covered up to a maximum of $50 per visit. This maximum applies each time an immunization or a vaccine is administered, if they are given on separate days. The office visit portion of the cost is subject to the per-visit maximum applicable under the Well-Baby Care provision described above.
• Physician's Office Visit expenses for emergency care of a sick child are covered in the same manner as Physician's Office Visits coverage for enrolled students under the Basic Level of the Plan.
• Outpatient Chemical Abuse Treatment coverage is available up to a maximum of 60 visits per policy year. Up to 20 of these visits must be available for family counseling visits. Coverage for each visit is provided in the same manner as Hospital Outpatient Services for students enrolled in the Basic Level of the Plan.
• Dependent coverage does not include benefits for Outpatient Mental Health Services or Elective Termination of Pregnancy. These benefits are available to students only through the Health Service Fee.

Premiums for Eligible Dependents

Lawful Spouse or Domestic Partner Only
Fall Premium: $2,061
Spring/Summer Premium: $3,197
Total Annual Premium: $5,258

Dependent Children Only
Fall Premium: $1,028
Spring/Summer Premium: $1,597
Total Annual Premium: $2,625

Lawful Spouse or Domestic Partner & Children
Fall Premium: $3,089
Spring/Summer Premium: $4,794
Total Annual Premium: $7,883

Funded graduate students* should contact their departmental administrator, financial aid or fellowship offices to determine if their program will pay for a portion of the cost for insuring their dependents prior to enrolling them. If the funding is approved, the students are provided with a confirmation stamp from their department. To enroll their dependents, funded students should download and complete the application and send the stamped copy with their portion of the premium directly to Aetna Student Health at the address provided on the application. Online enrollment is not available for funded graduate students because of the additional documentation requirement.

*Please note that funded students in GSAS may enroll their dependents online. The above process is provided for funded students in other academic programs.