Graduate Students
Graduate Student Healthcare Enrollment – Academic Year 2008-09 (Coverage effective September 1, 2008 – August 31, 2009)
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 25, 2008 - Deadline to submit enrollment forms for new or continuing coverage to be effective September 1, 2008.
- Monday, December 15, 2008 – Deadline to submit enrollment forms for new coverage to be effective January 1, 2009.
- Enrollment is required for each new plan year. Active coverage is canceled on August 31, 2008. 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. Refer to the new insurance rates located at http://gradcare.hr.pitt.edu/med.htm
Example: If you want medical coverage from September 1, 2008 through
August 31, 2009 for an individual – the monthly premium is $229.77 x 12
months = $2,757.24 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