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Coverage Comparable to the Colby-Billed Student Health Insurance Plans

All full time students are required to have health insurance coverage while attending Colby.  This Colby student health insurance plan premium of $2,070 will be billed to students by default if the health insurance enroll/waive online process is not completed by the prescribed deadline.   To enroll in or waive the school insurance go to the Wellfleet student website by August 1, 2022:  https://www.studentinsurance.com/Client/1481.  Students electing to waive Colby’s insurance coverage must provide proof of comparable coverage to the plan offered by Colby through Cross Insurance. Details about the required coverage, benefits summary, and list of exclusions and limitations can be found online in the health insurance brochure published by Cross Insurance.

The following guidance concerning comparability of coverage is offered:

*F2 and J2 visa-holders who are also enrolled full-time at Colby or a Colby-billed program are required to have health insurance, and are subject to the same comparable coverage guidelines described below.

  • The medical insurance plan must be provided by a U.S.­based carrier company or  U.S.­based subsidiary. Foreign insurance plans are not acceptable. Neither a  U.S.­based Third Party Administrator (TPA), nor a U.S. Satellite office of foreign company meets this requirement. The insurance carrier, itself, must be U.S.­based  (unless the student is studying outside the United States).
    • A U.S.­ based carrier means that the insurance carrier issuing the plan is a U.S. or domestic company, regardless of where the policy is purchased or where  the claims are processed. Carriers outside of the U.S. means foreign or foreign­ based insurance companies (i.e., non­-domestic or non­-U.S.  companies), including those companies with satellite offices in the United  States.  Travel insurance plans are not considered comparable coverage and would not qualify for a waiver.
  • The plan must provide reasonably comprehensive coverage of health services,  including preventive and primary care, emergency services, surgical services,  hospitalization benefits, ambulatory patient services, and mental health services, and  be reasonably accessible to the student for use in Central Maine. Plans not meeting this requirement are not acceptable.
    • Colby considers comparable coverage to provide reimbursement for more than just emergency medical services within the State of Maine (many regional HMO do not provide such coverage) and be compliant with the Affordable Care Act (ACA) by having out-of-pocket maximums at or below $8,150 per individual or $16,300 per family.
    • A health insurance plan which provides coverage through a closed network of  providers, not reasonably accessible in Central Maine, for all but emergency  services, does not qualify for a waiver.
    • Examples of closed networks include students enrolled in MassHealth or the Children’s Medical Security Program or the Health Safety Net, Kaiser Permanente Insurance and out of state Medicaid programs.
    • Health care sharing plans do not offer comparable coverage (examples:  Zion Health, One Share Health, Christian Healthcare Ministries) and would not qualify for a waiver.
  • Any plan may not impose an annual limit on the dollar amount of required essential health benefit for any covered individual.
  • Mental health and substance abuse must be covered as mandated by the State of  Maine.
  • There must be no limitations for the coverage of pre­existing medical conditions.
  • Prescription drug coverage must be as high as the plan maximum – as per ACA health  reform mandates.
  • If you will be studying outside your home country, emergency medical evacuation­ repatriation coverage must be included.
  • Embassy­-sponsored students for whom their embassy provides comprehensive U.S.  based coverage as described are eligible to waive, as indicated below.
  • The College currently limits embassy ­sponsored plans as deemed comparable to Wellfleet Insurance to those which provide fully comprehensive and  accessible domestic coverage.
  • An embassy­-sponsored plan that requires the student to pay up­front for ambulatory or hospital services, and then seek reimbursement will not be accepted. An embassy- sponsored plan that does not provide comprehensive  coverage including chronic disease management, prescription drug coverage, mental health services, and substance abuse will also not be accepted.

Students should compare the benefits, limitations, and exclusions of their alternate health insurance plan with those provided by the Colby College ­billed Student Health Insurance plan before filing their Health Insurance Waiver.

We understand that the details above are extensive.  If you do not know whether your  coverage meets the conditions above, contact your health insurance plan administrator to  get current, accurate information about your plan before completing the medical insurance  waiver. We can also assist you in the Colby College Health Center office. Call 207­-859­-4460  or email: ​ [email protected]​ with questions.