Beginning with the 1999-2000 academic year, graduate teaching assistants and graduate research assistants who have appointments which qualify for full tuition remission during academic semesters will receive, as an additional benefit, basic individual coverage under the University of Nebraska-Lincoln's student health insurance plan. This is being implemented in order to be more competitive in attracting and retaining outstanding students for the teaching and research mission f University of Nebraska-Lincoln Providing health insurance as a benefit to graduate assistants is becoming quite common among our peer institutions and UNL wants to remain competitive in recruitment of quality students. This document will provide background, a program overview and guidance about program details, definitions and restrictions.

Background
All students enrolled at UNL for seven or more hours during the academic semester are assessed Program and Facilities Fees (UPFF) in addition to tuition. These student fees allow students unlimited visits with Health Center primary care physicians and physician assistants at no additional cost. However, because there are charges for diagnostic testing and other procedures at the Health Center, students are encouraged to carry health insurance to cover these expenses. Every student at UNL has the opportunity to purchase a student health insurance plan. Nonimmigrant international students are required to have health insurance, they either purchase the student health insurance plan or show that they carry insurance coverage which is equivalent to the student policy coverage.

Program Overview
This UNL student health insurance plan is the same plan which will be purchased on behalf of eligible graduate assistants as a benefit of employment. The basic student health insurance plan has a premium of $399 per 12-month year, which corresponds to an academic year plus the following summer. Accidents and Illnesses are covered to a maximum of $50,000 per policy year. A student must be eligible to use the University Health (UHC) in order to qualify for the health insurance plan, because health care benefits under the student health insurance plan are closely tied to the services students receive at UHC. Eligible students are allowed unlimited visits with UHC primary care physicians and physician assistants at no cost and without a deductible amount; this policy helps to cover any additional expenses for diagnostic testing, other procedures or office visits to other physicians when the University Health Center is closed. To be eligible, a student must be enrolled for seven or more credits during academic year terms. A student enrolled in fewer than seven credit hours must pay the UHC fee in order to enroll in the insurance plan*. (The UHC fee plus the lesser UPFF assessed for fewer than seven credit hours is still somewhat less than the UPFF for seven or more hours.) Any student enrolled in the basic plan may elect to pay an additional premium of $105 to secure catastrophic coverage to a maximum of $950,000. Dependent plans are also available on an optional basis.

For graduate assistants paid from state-aided funds, the cost of this coverage will be paid from a central University fund. The cost of the benefit for graduate assistants paid from grants, contacts, or self-supporting sources will be assessed to the funding source. If a student is supported by more than one funding source, each source will provide a pro rata share which corresponds to the percentage of salary paid to the student from the funding source. (If salary cost is transferred at a later date to a different funding source, the cost f the health insurance benefit must also be transferred.)

Program Details
Students with eligible graduate assistant appointments will be enrolled automatically provided that the employment paperwork reaches the Office of Graduate Studies by specified deadlines. Students who wish to purchase dependent coverage or optional catastrophic coverage must do so by the deadlines specified. Should an automatically enrolled student which to decline the student health insurance, this must be done prior to the fourteenth day of classes each semester. In the case of international students, proof of equivalent insurance must be presented at the Student Health Center prior to the fourteenth day of classes each semester. However, after the fourteenth day of classes, the student health insurance will remain in force until the end of the coverage period.

The University of Nebraska-Lincoln will pay the amount of the annual premium of individual coverage for eligible graduate assistants. If a graduate assistant wishes to add dependent coverage or the optional catastrophic plan at the student's own expense, payment plans are available. Nonimmigrant international students will be responsible individually for payment of the required repatriation and medical evacuation insurance. That coverage costs approximately $20 per policy year.

Program Definitions
Eligibility for health insurance--any UNL student enrolled for at least 1 hour in a credit course who has paid the UHC fee and enrolls before the deadline (September 21 for domestic students and September 7 for international students) for coverages available in the Fall semester or before February 8 for coverages available in the spring semester. (The Spring deadline applies equally to domestic and international students).

Eligibility to be a graduate assistant--student must be admitted t a department or interdepartmental area with a specific graduate degree objective and enrolled during the period of the assistantship.

Eligibility for graduate assistant to obtain tuition waiver and health insurance benefit--graduate assistant salary paid between August and May must be at least equal to cost of nonresident tuition and fees for a full-time student and further the graduate assistant must work in the range of 13-20 hours weekly for at least four months within the dates of each academic semester.

Program Restrictions
Students must be register (ore preregistered) in order for the health insurance application to be processed.

Students must attend classes for at least the first 31 days of the semester. If a student withdraws from classes within that period, coverage will be null and void and the premium will be refunded to the funding source. If the withdrawal is after that date, coverage will remain in force for the full period for which the premium is paid, no refund will be allowed. (Note: students may use the UHC for one term after ceasing to be considered a student, if the UHC fee is paid.) Graduate assistants who lose eligibility for tuition waiver (whether because of resignation, termination of employment or withdrawal from UNL) will be billed for the cost of tuition for the applicable semester and the cost of the health insurance premium.

Un-enrolled students who wish to use the UHC in the summer following the academic year enrollment may do no by paying the UHC fee for the summer. This also applies if the student has a minimal enrollment for the summer sessions. However, if the student is enrolled during the summer for at least four credits per session the UHC fee will have been paid by virtue of the assessed UHC fee paid by the student.

This program is financed beginning with the academic year 1999-2000. If a student begins employment during the summer of 1999, health insurance will remain the student's responsibility until the program begins in the Fall semester. Guidelines and policy for students beginning employment in summer 2000 or following summer periods will be established at a later date.

*The 98-99 UNC fee is currently $92.12 per academic year semester and totals approximately $75 for the 1999 summer sessions.

FOR INSURED STUDENTS -- premium for 12 month contract year is $399.
Costs beyond the office visits (i.e., diagnostic tests, other procedures).

If done at University Heath Center, no deductible, benefits paid at 100% for eligible costs.

If done outside UHC, deductible is $150 (per contract year), benefits paid at 80% up to $2,500, then benefits paid at 100%.

Hospital miscellaneous expenses are paid at 100%.

COVERED EXPENSES
INPATIENT
- Room & board, daily semi-private room rate and general nursing care by hospital.
- Hospital miscellaneous expenses. Operating room, lab tests, x-rays, anesthesia, drugs and medicines (excluding take-home drugs), therapeutic services and supplies. Notes: Inpatient hospital benefits are subject to a $1,800 maximum for the first and second days combined and a $600 daily benefit maximum thereafter, (for each covered accident or sickness). No coinsurance is applied.
- Physical therapy.
- Surgeon's fees. No more than one surgical procedure will be covered when multiple procedures are performed through the same incision.
- Assistant surgeon.
- Anesthetist. Benefits are payable at 25% of the surgery allowance.
- Private duty nurse.
- Physician's visits. Benefits are limited to one visit per day and do not apply when related to surgery.
- Pre-admission testing.
- Psychiatric care benefit. Psychiatric hospitals are not covered. - Psychiatric care must be administered by a medical doctor (M.D.), licensed psychologist (Ph.D.) Or licensed mental health practitioner (LMHP). Note: Benefits are subject to a $5,000 contract year minimum

OUTPATIENT-(UHC referral required for students)
- Surgeon's fee
- Day surgery expenses. When surgery is scheduled and performed in a hospital. Note: benefits are subject to an $850 maximum, per covered accident or sickness. No coinsurance is applied.
- Anesthetist. Benefits are payable at 25% of the surgery allowance.
- Physician's visits. Benefits are limited to one visit per day and do not apply when related to surgery.
- Physical therapy. Benefits are limited to one visit per day.
- Medical emergency expenses. The use of the emergency room and supplies.
- Diagnostic x-ray and lab services; radiation and chemotherapy.
- Injections. When administered in the physician's office and charged on the physician's statement.
- Psychiatric care. Must be administered by a medical doctor (MD) licensed psychologist (PhD) or licensed mental health practitioner (LMHP). Note: Benefits are subject to a $30 daily maximum, 10-day maximum each contract year.
- Tests and procedures. Diagnostic services and medical procedures performed by a physician, excluding physician's visits, physical therapy, x-rays, and lab procedures (which are payable as shown above).

OTHER
- Ambulance services.
- Durable medical equipment. A written prescription must accompany the claim when submitted. Replacement braces and appliances are not covered.
- Consultant physician fees, when requested and approved by the attending physician.
- Dental treatment due to injury to sound, natural teeth.
- Pregnancy and complications of pregnancy.

NON-COVERED SERVICES--No benefits are available for the following:
- Acne surgery and/or treatment.
- Acupuncture
- Allergy testing and allergy vials (except for allergy testing done at UHC).
- Benefits for expenses incurred in the absence of an accident or sickness; routine physical exams and routine testing; preventive testing or treatment; screening exams or testing.
- Biofeedback-type services.
- Birth control.
- Breast implants or breast reduction.
- Circumcision
- Congenital conditions, except as specifically provided for newborn infants.
- Corns, calluses and bunions.
- Cosmetic procedures (except cosmetic surgery required to correct an injury for which benefits are otherwise payable under this contract).
- Dental treatment, except for accidental injury to sound, natural teeth.
- Deviated septum, including submucous resection and/or other related surgical correction.
- Elective abortion.
- Elective treatment and elective surgery and any complications.
- Eye exams, prescriptions of fitting of eye glasses and contact lenses; radial keratotomy or other treatment for visual defects and problems. "Visual defects" means any physical defect of the eye which does or can impair normal vision.
- Family planning, fertility tests, impotence, infertility (male or female), including any services or supplies rendered for the purpose or with the intent of inducing conception.
- Hearing exams or hearing aids; or other treatment for hearing defects and problems. "Hearing defects" means any physical defect of the ear which does or can impair normal hearing.
- Injury caused by, contributed to or resulting from the use of alcohol, illegal drugs, or any drugs or medicines that are not taken in the dosage or for the purpose prescribed by the covered person's physician.
- Injury or sickness for which benefits are paid or payable under any Workers Compensation or Occupational Disease Law or Act, or similar legislation; or collectible under other valid and collectible insurance.
- Injury caused by, contributed to or resulting from the use of alcohol, illegal drugs, or any drugs or medicines that are not taken in the dosage or for the purpose prescribed by the covered person's physician.
- Injury or sickness for which benefits are paid or payable under any Workers compensation or Occupational Disease.
- Law or Act, or similar legislation; or collectible under other valid and collectible insurance.
- Injury sustained while a) participating in any interscholastic, club, intercollegiate or professional sport, contest or competition; b) traveling to or from such sport, contest or competition as a participant; or c) while participating in any practice or conditioning program for such sport, contest or competition (except intramural sports).
- Learning disabilities.
- Nonmalignant warts, moles and lesions.
- Obesity and nay resulting condition (including hernia)
- Organ transplants.
- Participation in a riot or civil disorder, commission of or attempt to commit a felony or fighting except in self defense.
- Pre-existing conditions except under he Basic Plan only for individuals who have been continuously insured under the school's student insurance contract for at least 12 consecutive months. There is no coverage for pre-existing conditions under the Optional Catastrophic Plan.
- Premarital examinations.
- Prescription drugs dispensed or purchased while not confined to a hospital.
- Preventive medicines or vaccines, except where required for the treatment of a covered injury.
- Routine newborn baby care, well-baby nursery and related physician charges.
- Services normally provided without charge by the UHC or any other person employed or retained by the University; or services covered or provided by the student health fee.
- Sexual reassignment surgery.
- Skeletal irregularities of one or both jaws, including orthognathia and mandibular retrognathia.
- Skydiving, parachuting, bungi-cord jumping, hang gliding, glider flying, parasailing, sail planing of planing or flight in any kind of aircraft, except while riding as a passenger on a regularly scheduled flight of commercial airline.
- Sleep disorders and related testing.
- Suicide or attempted suicide while sane or insane (including drug overdose); or intentional self-inflicted injury.
- Temporomandibular jaw joint dysfunction.
- Treatment in government hospital, unless there is a legal obligation for the covered person to pay for the treatment.
- Tubal ligation
- Vasectomy.
- Sickness or injury caused by war or any act of war, declared or undeclared; or while in the armed forces of any country (a pro-rata premium will be refunded upon request for such period not covered).
- Weight reduction.