University Requires Students to Opt-In or Opt-Out of New Insurance Plan


Marisa Valentino/The Fordham Ram

Fordham debuted a health insurance plan for its students this year.

Fordham University has implemented changes to the student health insurance policy, effective Aug. 23. With the current plan, all full-time undergraduate students and graduate students taking six or more credits must have health insurance. Those who are not what the university considers “adequately” covered by external policies are required to pay for the university plan provided by Aetna, which costs a yearly premium of $3,073.

Additionally, the policy is now opt-out instead of opt-in. Previously, in order to obtain health insurance from the university, a student would have to request it. Now, to opt-out of university health insurance, one must complete a yearly waiver with proof of adequate insurance.

Gregory J. Pappas, assistant vice president for Student Affairs, said the university implemented the new insurance plan after changes to the Affordable Care Act (ACA) prior to the academic year. ACA no longer requires citizens over the age of 18 to have health insurance, so the university has implemented its own policy that ensures all students are covered in case of medical issues. In addition, Pappas said the mandatory waiver program is necessary because there are no carriers that would underwrite a voluntary plan.

“Ultimately, prior to this year, students were required by the government-enforced ACA to have some form of health insurance, but now, in order to attend Fordham University, students must have some form of health insurance,” Pappas said.

According to the university website, a student’s insurance plan must be ACA compliant and not require students to pay for treatment out-of-pocket and then be reimbursed in order to opt-out. All waivers had to be submitted by Sept. 10 to opt-out for the 2019–20 academic year, and incoming students for the spring semester must submit a waiver by Feb. 23.

Health Insurance Compliance Administrator Maritza Rivera-Garcia said the number of waivers submitted for the 2019–20 academic year was 13,545 out of 16,515 undergraduate and graduate students meaning about 82% of students opted-out.

Rivera-Garcia said that beyond the changes to ACA, student requests for competitively priced healthcare coverage made it necessary for the university to implement a new policy. According to Pappas, the university has been able to maintain its insurance premium and benefits because of the increased participation level of the program.

“The current plan is more beneficial because when you have a higher participation level, you can keep your premium at a more stable cost and you can improve your benefit structure moving forward,” Pappas said. “If you have a lower participation level, you won’t have as many healthy students off-setting the expenses of students who have health issues.”

Additionally, Pappas said if a student were to buy a comparative plan on an individual basis on the open market, the premium would be significantly more expensive.

“An opt-out waiver plan is beneficial, as it addresses the needs of all parties, especially by offering a comprehensive benefit package at an affordable annual premium for those students with pre-existing conditions,” Pappas said. “Fordham University understands the importance of offering a variety of comprehensive services, including a student health insurance plan with solid coverage at an affordable price for the entire student body.”

Fordham’s website defines its coverage as including primary care, emergency services, surgical services, hospitalization benefits, ambulatory patient services and mental health services. The plan also provides coverage for lab work, diagnostic x-rays, physical therapy, chiropractic care and prescriptions. The website says these services are “reasonably accessible,” and in close relation to all school campuses.

Rivera-Garcia said services include doctors, specialists, prescriptions, hospitals, mental health and prevention care. She said the only services not covered are dental and optical — the plan is only for medical coverage.