Using Your Benefits

View Insurance Benefits Online

To view this year's Student Insurance Plan online, follow these steps:

  • Go to http://www.somerton-ins.com/
  • Under Student Insurance, click "Policy Borchures" 
  • Select State
  • Select "Independents"
  • Select "View Schools"
  • Select "Simpson University" and click "Brochure" 
  • Scroll down to the fourth screen for Schedule of Benefits.

Plan Basics

  1. Only illness and injuries are covered. Routine physicals and women's health screenings are not covered.
  2. This plan is secondary to all other insurance plans. This means that if you have dual insurance, both plans must be billed. The Simpson Plan will not pay any benefits until the primary company has paid whatever they will cover. An Explanation of Benefits from the primary insurance must be mailed to the Student Plan before any payment will be made.
  3. You will receive a member card after you enroll in the Student Insurance Plan (SIP), carry it in your wallet. Each time you see a doctor or other medical provider, have them copy it so they can bill the insurance.  This card is also used for prescriptions.

Preferred Providers

You may use any doctor you choose, but out of pocket expenses may be less if you use those in the Preferred Provider network (PPO).

To find a list of PPO doctors in Redding, go to the website listed on your card for the Community Care Network (http://www.ccnusa.com/). Click on "Find a Provider" and then on "Group Health" and then on "PPO"  under that.

SUBMIT A CLAIM FORM FOR EACH DIAGNOSIS FOR WHICH YOU:

  • Are seen by a physician
  • Get a prescription
  • Have lab work
  • Use the emergency room
  • Are hospitalized

Only one claim form per diagnosis or accident is required.

CLAIM FORMS are available at the Health Center (HSLC 109)

If a claim form is not submitted as above, your claim will not be paid.

The Prescription Benefit

  1. Benefit is limited to $200 per year (September 1 - August 31).
  2. Your co-pay for generic prescriptions is $5, and for brand name, $10.
  3. You may use any of these pharmacies: Costco, Long's, Rite-Aid, Safeway, ShopKo, Target, Walgreens, and Wal-Mart

In September and January, before Express Scripts receives our completed enrollment roster, you will need to pay the full price and mail in the receipt for reimbursement, along with a completed claim form.

Call the Health Center (226-4178) or email jkayser@simpsonuniversity.edu  or come in (HSLC 109) and our nurse will be glad to answer your questions.
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