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Dear Chamberlain College of Nursing Student,
The personal health of students is of the utmost importance in providing safe and professional nursing care. Maintaining personal health insurance is one way to protect yourself and those you care for in the clinical environment. Proof of health insurance is also required by Chamberlain’s clinical partners.
Chamberlain students are required to demonstrate proof of health insurance prior to the first day of class, and annually thereafter, by completing Option 1 or Option 2 listed below. The deadline is the Sunday prior to the first day of your first semester at Chamberlain and each new policy year thereafter.
Failure to provide personal health insurance documentation by the deadline will result in auto enrollment in the UnitedHealthcare ® (UHC) Injury and Sickness Plan. For a listing of current insurance rates please visit chamberlain.edu/studentinsurance . Your Chamberlain student account will be charged. If you need to purchase coverage, please review the UnitedHealthcare’s Student Injury and Sickness Plan summary located at chamberlain.edu/studentinsurance to determine which plan best meets your individual needs or visit studentcenter.uhcsr.com/chamberlain for additional plan information.
ACTION REQUIRED: All students are required to select one of the options below and follow the corresponding steps to complete your health insurance requirement. Failure to take action will result in auto enrollment in the UnitedHealthcare ® (UHC) Student Injury and Sickness Plan.
OPTION 1:
Verification of personal health insurance
1. My signature below acknowledges that I will not be joining the Chamberlain
College of Nursing sponsored student health insurance plan because I have comparable coverage to the health benefits of the Chamberlain College of
Nursing plan.
2. I fully understand that I am legally responsible for any medical expenses incurred during my enrollment at Chamberlain College of Nursing and that
Chamberlain College of Nursing will not be responsible for any medical expense. It is also understood by me that if I lose my medical insurance protection, I will notify the Chamberlain Health Insurance Administrator and make necessary arrangements to join the sponsored plan.
3. For Certified Profile users, upload this completed form along with a copy of the front and back of your insurance card to your profile. For all other students, fax the completed form, along with a copy of the front and back of your insurance card to the National Clinical Compliance Office at 877.308.8663 to complete the health insurance requirement.
Print Name:
Signature:
Date:
STUDENT ID:
CAMPUS:
OPTION 2:
Enrollment in UnitedHealthcare’s Student Injury and Sickness Plan
(Enrollment Form)
1. Visit studentcenter.uhcsr.com/chamberlain .
2. Click on the Enrollment Card link.
3. Complete the enrollment card form.
4. Choose the appropriate campus location.
5. Put your correct Chamberlain email address on the electronic form.
6. Click the Submit button upon completing the electronic form.
7. For Certified Profile users, upload a copy of the UHC enrollment form to your profile. For all other students, fax a copy of the UHC enrollment form to the
National Clinical Compliance Office at 877.308.8663 to complete the health insurance requirement.
Your student account will be charged within the first two weeks of a new term.
UnitedHealthcare will send a confirmation email within 10 days of enrollment. Your insurance card is digital unless you request otherwise.
To print a copy of your card or to request a permanent card via mail go to the UHC website at studentcenter.uhcsr.com/chamberlain .
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