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HEALTH AND WELLNESS CENTER REFERRAL

When at school, in the absence of a Medical Emergency, the student's first visit should be to the Northampton Community College Health and Wellness Center .

T h e H e a l t h a n d W e l l n e s s C e n t e r o f f i c e i s o p e n d u r i n g F a l l a n d S p r i n g S e m e s t e r s :

Monday - Friday

.................................

8 : 3 0 a . m . t o 4 : 3 0 p . m .

The Health and Wellness Center office is closed Saturday, Sundays, holidays, and vacations. It is open limited hours during the Summer.

DEPENDENTS

Y o u r l a w f u l s p o u s e a n d u n m a r r i e d d e p e n d e n t c h i l d r e n u n d e r a g e 1 9 w h o a r e n o t s e l f - s u p p o r t i n g , s t e p c h i l d r e n , f o s t e r c h i l d r e n , l e g a l l y a d o p t e d c h i l d r e n , a n d c h i l d r e n o f a d o p t i v e p a r e n t s p e n d i n g a d o p t i o n p r o c e e d i n g s m a y a l s o b e c o m e C o v e r e d P e r s o n s . D e p e n d e n t s m u s t b e e n r o l l e d f o r t h e s a m e c o v e r a g e a s t h e s t u d e n t . D e p e n d e n t c h i l d r e n w i l l c o n t i n u e t o b e e l i g i b l e f o r c o v e r a g e i f a t t h e a g e o f 1 9 t h e c h i l d i s ( 1 ) i n c a p a b l e o f s e l f - s u s t a i n i n g e m p l o y m e n t b y r e a s o n o f m e n t a l r e t a r d a t i o n o r p h y s i c a l h a n d i c a p a n d ( 2 ) c h i e f l y d e p e n d e n t u p o n t h e s t u d e n t i n s u r e d f o r s u p p o r t a n d m a i n t e n a n c e . P r o o f o f t h e i n c a p a c i t y a n d d e p e n d e n c y s h a l l b e f u r n i s h e d t o t h e i n s u r e r b y t h e I n s u r e d w i t h i n 3 1 d a y s o f t h e c h i l d r e a c h i n g a g e 1 9 . C o n t i n u e d p r o o f s h a l l b e f u r n i s h e d t o t h e i n s u r e r o n a n a n n u a l b a s i s t h e r e a f t e r . D e p e n d e n t c o v e r a g e e x p i r e s c o n c u r r e n t l y w i t h t h a t o f t h e c o v e r e d s t u d e n t .

You are under no obligation to enroll dependents in this coverage. However, you must enroll for this coverage for your dependents and pay the required premium before their coverage will take effect.

N e w b o r n C h i l d r e n - A l l n e w b o r n c h i l d r e n o f a n y C o v e r e d S t u d e n t a r e a u t o m a t i c a l l y c o v e r e d a t b i r t h f o r 3 1 d a y s f o r t h e s a m e b e n e f i t s a s p r o v i d e d t o C o v e r e d P e r s o n s . C o v e r a g e a p p l i e s f o r a n y c o v e r e d I n j u r y o r S i c k n e s s c o m m e n c i n g d u r i n g t h e 3 1 d a y p e r i o d f r o m t h e d a t e o f b i r t h i n c l u d i n g a b n o r m a l i t i e s , p r e m a t u r i t y , m e d i c a l l y d i a g n o s e d c o n g e n i t a l d e f e c t s a n d r o u t i n e n u r s e r y c a r e . T h e C o v e r e d S t u d e n t m a y c o n t i n u e c o v e r a g e b e y o n d 3 1 d a y s u p o n e n r o l l m e n t w i t h i n t h e 3 1 d a y p e r i o d f r o m t h e d a t e o f b i r t h . A c h i l d a d o p t e d b y a C o v e r e d S t u d e n t w i l l b e c o v e r e d o n t h e s a m e b a s i s a s a n e w b o r n c h i l d f r o m t h e d a t e o f p l a c e m e n t f o r t h e p u r p o s e o f a d o p t i o n . C o v e r a g e w i l l c o n t i n u e u n l e s s t h e p l a c e m e n t i s d i s r u p t e d p r i o r t o l e g a l a d o p t i o n a n d t h e c h i l d i s r e m o v e d f r o m p l a c e m e n t .

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PREMIUM REFUND POLICY

Except for medical withdrawal due to an Injury or Sickness, any student withdrawing from the school during the first 31 days of the period for which coverage is purchased shall not be covered under this Plan and a full refund of the premium will be made. Students withdrawing after 31 days will remain covered under this Plan for the full period for which the premium has been paid and no refund will be made available. Premiums received by the Company are fully earned upon receipt.

Coverage for a Covered Person entering the Armed Forces of any country will terminate as of date of such entry. Those Insured Students withdrawing from the school to enter military service will be entitled to a pro-rata refund of premium upon written request within 90 days.

TERMINATION OF INSURANCE

B e n e f i t s a r e p a y a b l e u n d e r t h i s P l a n o n l y f o r t h o s e e x p e n s e s i n c u r r e d w h i l e t h i s P l a n i s i n e f f e c t a s t o t h e I n s u r e d P e r s o n . N o b e n e f i t s a r e p a y a b l e f o r e x p e n s e s i n c u r r e d a f t e r t h e d a t e t h e i n s u r a n c e t e r m i n a t e s f o r t h e C o v e r e d P e r s o n , e x c e p t a s m a y b e p r o v i d e d u n d e r E x t e n s i o n o f B e n e f i t s .

EXTENSION OF BENEFITS

The coverage provided under the policy ceases on the Termination Date. However, if an Insured is totally disabled on the Termination Date from a covered Injury or Sickness for which benefits were paid before the Termination Date, covered medical expenses for such Injury or Sickness will continue to be paid for a period not to exceed 30 days after the Termination Date. The total payments made for such condition, both before and after the Termination Date, will never exceed the Maximum Benefit. After this "Extension of Benefits" provision has been exhausted, all benefits cease and no further payments will be made.

OTHER COVERAGE OPTIONS

I n s u r e d S t u d e n t s n o t e l i g i b l e t o r e - e n r o l l i n t h e S t u d e n t A c c i d e n t a n d S i c k n e s s I n s u r a n c e P l a n a f t e r y o u r c o v e r a g e u n d e r t h e P l a n e x p i r e s , d u e t o g r a d u a t i o n o r d i s c o n t i n u a t i o n o f s t u d i e s a t t h e C o l l e g e , m a y e l e c t t o p u r c h a s e o t h e r c o v e r a g e .

Contact Collegiate Insurance Resources for enrollment information prior to the expiration of student coverage.

Students in need of specialized coverage (International Travel or Long Term Major Medical) should contact Collegiate Insurance Resources for options.

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