Frequently Asked Questions

When does my coverage become effective?
If you complete the health insurance enrollment form within 30 days of your appointment start date your health insurance will be effective on the same date as your appointment start date. If the enrollment form is completed after 30 days of your appointment start date there will be a 30 day waiting period before your health insurance coverage is active.
What is the name of the health insurance?
  • The Medical part of the health insurance plan is administered by POMCO. Your affiliated provider is Beechstreet.
  • The Dental benefits are administered by Delta Dental and the Vision benefits through Davis Vision.
How do I know which doctors accept this health insurance?
You may visit the following websites to view a list of participating providers, please note that the medical, dental, and vision benefits are administered by different companies and therefore have different lists of participating providers.
May I see a doctor who does not participate in the Medical/Dental/Vision plan?
  • Medical: Yes, however it will be covered at an out-of-network benefit. This means you are subject to a $100 deductible and the insurance company only pays 80% of allowable charges, you are responsible for the rest.
  • Dental: Yes, however payment is calculated on a Usual, Customary, and Reasonable (UCR) basis. Delta pays you and you are responsible to pay the dentist total fee, which may include amounts in addition to the UCR.
  • Vision: No, there is no out-of-network benefit.
When can I expect to receive my health insurance ID card?
Once your enrollment form is received and processed, by the Student Health Insurance Office; it typically takes about 2-3 weeks to receive a card. The card is mailed, from POMCO, to the address on your enrollment form. If you do not receive your card within 2-3 weeks you may contact POMCO directly at 1-866-317-2098.
Is my health insurance active without the card?
  • Medical: Yes, if you require medical care before receiving a card but you may need to pay the bill in advance or have your doctor bill you. If you pay the bill in advance you will need to mail a copy of the paid receipt and a copy of the card, to the insurance company, for reimbursement. If your doctor will bill you then mail the bill and a copy of your card to the insurance company for payment.
  • Dental: You will NOT receive a card for dental. The Student Health Insurance Office distributes a dental information brochure; this contains our Group # 1996. The participating dentist needs this information in order to bill Delta.
  • Vision: You will NOT receive a card for vision. When you visit a participating provider you will need to do is identify yourself as a member or covered dependent of the Research Foundation of SUNY Graduate Student Employee Health Plan; you will also need to provide your social security number.
Do I need to select a Primary Care Physician (PCP)?
No, the insurance company does not require you to have a PCP to use your medical benefits.
Why did my bill get rejected by the insurance company?
There are several reasons this could happen, you will need to contact the insurance company directly to find out why your claim was rejected. Please be advised that The Student Health Insurance Office does not handle claims and therefore is not able to discuss your claims with the medical provider or insurance company.
Why is my Emergency Room bill not being paid by the insurance company?
You need to contact the POMCO directly at 1-866-317-2098. You may have to write an appeals letter. Please see your handbook for further directions.
Why am I getting billed for the Foreign Student Health Insurance when I have health insurance deducted from my paycheck?
An adjustment will be made to your student accounts bill during the month of October for the Fall semester and by February for the Spring semester. If you do not see the adjustment by then contact Edmond Anderson at the Student Health Insurance Office (631) 632-6144.
I completed an enrollment form, why don't I see deductions from my paycheck yet?
Please allow 2-3 weeks for your form to be processed. If you do not see deductions after that then contact Edmond Anderson at the Student Health Insurance Office at (631) 632-6144 to confirm that we have received your form.
I elected family health coverage, but I only see deductions from my paycheck for individual coverage. What should I do?
You should contact Edmond Anderson at the Student Health Insurance Office at (631) 632-6144 to have this corrected, otherwise you will experience problems with coverage.
What happens to my health insurance during the semester break in January?
If you are in an active payroll status (receiving a paycheck) health insurance will continue. If you are not receiving a paycheck, health insurance will end as indicated below.
What happens to my health insurance over the summer when I'm not receiving a paycheck?
If you were an RA and are returning in the fall as an RA you may be eligible to continue your coverage over the summer by completing the Continuation of Health Insurance for Summer form. A lump sum health insurance premium will be deducted from your paycheck in May to cover the entire summer. More information on the coverage over the summer months can be found at www.stonybrook.edu/hr
What should I do if my funding changes from Research Foundation to State?
You should come to the Student Health Insurance office and complete the state health insurance enrollment form.
What happens to my health insurance once my employment ends?
Your health insurance will end 28 days after the last day of the last payroll period worked. During this time you will receive a COBRA letter describing how to continue health insurance. You may continue coverage at group rates (plus a 2% adminsitration fee) for up to 18 months.

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