Gallagher is the insurance agency that Georgetown University (GU) selected to customize the 2016-2017 Premier Plan. Gallagher creates customized health plans for other universities as well. Gallagher distributes the insurance identification cards, answers benefit questions (1-877-362-5287), and coordinates components of the Premier Plan for GU students with:
- GU Student Health Insurance
- United HealthCare StudentResources, the third party claims administrator with service tools such as: online claims lookup and secure correspondence;
- United HealthCare Network Pharmacy, the prescription card company, 1-855-828-7716;
- United HealthCare, the insurance company that holds the risk;
- United HealthCare Options, the preferred providers with contracted discounts;
- AdvoCare, the pre-certification company for select benefits;
- UHC Global, the travel assistance company;
- United HealthAllies Discount Network, a dental, vision, and pharmacy discount network card;
- Basix an additional dental discount network, and
- EyeMed a vision discount network.
The Premier Plan is a medical injury and sickness insurance plan. If you need additional insurance coverage, e.g., dental coverage, contact an insurance agent to find out what additional plans are available to purchase.
STUDENTRESOURCES IS THE STUDENT HEALTH INSURANCE CLAIMS ADMINISTRATOR FOR UNITED HEALTHCARE
United HealthCare StudentResources (UHCSR) is the "third party claims administrator," the company responsible for reviewing claims and "cutting checks" according to the plan design. If you have questions about the status of your claim, contact StudentResources or go to the StudentResources website, log into UHCSR's "My Account", and access your online claims information.
UNITED HEALTHCARE NETWORK PHARMACY
For the convenience of purchasing pharmacy drugs, students have access to the United HealthCare (United) Network Pharmacy including the United pharmacy discounts.
UNITED HEALTHCARE (UNITED)
United HealthCare is the insurance company that has the financial strength to pay for the covered claims, even if United did not charge enough premium for all the covered claims filed against the Premier Plan. In other words, the Premier Plan is fully insured, and United holds the financial risk for paying your covered health insurance claims and has a 2009 AM Best rating of A, excellent.
Covered students' enrollment files are maintained by Student Resources, the student health insurance claims administrator owned by United; Arthur J. Gallagher Student Health and Special Risk insurance agency; and Georgetown University Student Health Insurance.
UNITED HEALTHCARE OPTIONS PREFERRED PROVIDER NETWORKS
To manage plan costs, students are encouraged to seek providers who have agreed to a discounted fee schedule. Out-of-pocket costs for students will be less if services are obtained from a United Preferred Provider when in the United States. The GU Student Health Center is a United Preferred Provider under Schedule 1 and Georgetown University Hospital/Medstar is a United Preferred Provider under Schedule 2.
In-patient admissions, allergy testing services, and anticipated maternity admissions within 3 months of pregnancy must be pre-certified by AdvoCare to enable the claims administrator to evaluate medical necessity and/or high risk conditions.
UNITED HEALTHCARE GLOBAL EMERGENCY MEDICAL ASSISTANCE
To assist insureds when traveling abroad, United HealthCare Global (UHC Global) Emergency Medical Services are available to students, including translation and provider referral services. UHC Global Emergency Medical Services is not health insurance; it is a travel assistance service for health care. In order for travel services rendered to be considered for payment by the Premier Plan, the services must be arranged and provided by UHC Global.
UNITED HEALTHALLIES DISCOUNT NETWORK
In addition to the covered benefits described in the Schedule of Benefits, insureds have access to discounts for prescription, dental, and vision services when those services aren't otherwise covered under the Premier Plan. For example, the Plan does not cover most dental and vision services as indicated in exclusions 6 and 7 of the Premier Plan Description of Benefits. However, insureds can access discounts by going to United HealthAllies' Providers.
Go to www.sr.unitedhealthallies.com to obtain a United Health Allies ID Card and to identify United HealthAllies Providers offering service discounts.
BASIX DENTAL SAVING PROGRAM (BASIX)
Arthur J Gallagher Student Health and Special Risk has arranged for students enrolled in the Premier Plan to have access to the Basix Dental Savings Program. Basix has contracted discount fee schedules with local dentists. The dentists and fee schedules are on the Basix website. Present your Premier Plan Identification Card to the Basix providers to access the discounts.