Graduate Students
Graduate Student Healthcare Enrollment – Academic Year 2009-2010 (Coverage effective September 1, 2009 – August 31, 2010)
If you’re interested in continuing your current medical coverage or are a new student interested in applying for coverage, please read the following information.
- Monday, August 24, 2009 - Deadline to submit enrollment forms for new or continuing coverage to be effective September 1, 2009.
- Monday, December 14, 2009 – Deadline to submit enrollment forms for new coverage to be effective January 1, 2010.
- Enrollment is required for each new plan year. Active coverage is canceled on August 31, 2009. To continue coverage, eligible students must re-enroll.
- Full-time and part-time eligible students may apply.
- Annual premium is due at the time of enrollment (no quarterly payment options are available).
Special Instructions
If you are making an election to cover for the FIRST time a spouse, domestic partner, or child(ren) with medical, vision and/or dental coverage, documentation of the relationship is required.
- For a spouse, include a copy of a marriage certificate with the enrollment form, otherwise your election will not be put into effect.
- For dependent child(ren), include a copy of the birth certificate(s), otherwise your election will not be put into effect. Paperwork for adopted children or stepchildren is also applicable.
- For a domestic partner, contact the Office of Human Resources Benefits Department at (412) 624-8050 to schedule an appointment for review of a completed Affidavit of Domestic Partnership, and documentation for dependent children, (which may require adoption paperwork) along with an enrollment form.
- If you are making an election to delete a spouse or domestic partner because of the end of a relationship, a copy of a divorce decree or dissolution form is required.
Submit one (1) enrollment form with separate checks made payable to each vendor.
If you are enrolling in the UPMC medical plan: make checks payable to “UPMC Health Plan”
If you are enrolling in the vision plan: make checks payable to “Davis Vision”
If you are enrolling in the dental plan: make checks payable to “United Concordia”
Checks must be made payable to the appropriate vendor for the ANNUAL PREMIUM amount for each vendor. Academic year 2009-2010 insurance rates, enrollment form and benefit details will be posted at the following link: http://gradcare.hr.pitt.edu/med.htm. Please be sure to check back for the most current information or contact Nicole Gannon at nmgannon@pitt.edu for current rates.
Example: If you want medical coverage from September 1, 2009 through
August 31, 2010 for an individual – the monthly premium is $242.37 x 12
months = $2,908.44 total check amount made payable to UPMC Health Plan
Please take notice of this information to avoid any delays/problems with coverage.
Submit your enrollment form, separate checks & any required supporting documents to:- Nicole Gannon
University of Pittsburgh School of Nursing
3500 Victoria Street
239 Victoria Bldg.
Pittsburgh, PA 15261
Questions: Contact Nicole Gannon @ (412) 624-6910 or nmgannon@pitt.edu