DSGHP Information

2019-2020 DSGHP PLAN YEAR COVERAGE INFORMATION

COMING SOON

2018 - 2019 DSGHP Plan Year Coverage Information

Fees

  • Student only: $3,073.00
  • One Dependent: $5,210.00
  • Two or more dependents: $7,446.00

The cost of the plan for dependent coverage is in addition to the cost of the plan for student coverage. Spouses and domestic partners enrolled into the plan, are subject to an annual spouse/domestic partner health access fee.

A new Dependent Application must be submitted to the DSGHP Office by the start of each plan year, as dependent enrollment is not automatic.

For "per term" enrollment fees (exchange students or study abroad enrollments), please contact the DSGHP office.

Coverage Dates

  • New Students: August 1, 2018 – August 31, 2019
  • Returning Students: September 1, 2018 – August 31, 2019

Coverage for current plan year terminates on August 31st, unless a student submits a Waiver or Midyear Cancellation Form to cancel on December 31st or March 31st.

Claim and Network Information

Claims for services at an out-of-network provider are to be submitted to the Plan for payment within ninety (90) days after services are received and payment is requested.  In-network providers must submit a claim for payment within twelve (12) months of the date of service. 

HealthSmart (Claims Administrator)

  • View or print ID cards and claims
  • View coverage information
  • Network information
  • Claim forms (Medical & Prescription)
  • Pharmacy Formulary

Cigna PPO Providers (to find an in-network provider)

Basix Dental Savings Program

  • Members of the DSGHP have access to the Basix Dental Savings Program, which is a network of dentists who have agreed reduce charges for dental services. Visit the Basix website to find a dentist, and see what their discounts are, all over the US.

Forms

Midyear Enrollment

  • To enroll into the DSGHP after September 1st, due to an involuntary loss of other coverage, or during the terms you are enrolled into a study abroad program.

Midyear Cancellation

  • To cancel the DSGHP coverage for student or dependent(s) on one of the two midyear cancellation dates.

Dependent Application

  • To enroll qualifying dependents.

DSGHP Tax Forms & When Coverage Ends Information

  • 1099HC (Massachusetts residents only)
  • 1095B (All DSGHP enrollees)
  • Extending DSGHP coverage after leaving the college
  • HIPAA letter (Proof of coverage terminating, typically needed for enrollment in other health/insurance plans)

On Campus Services & Resources

DSGHP Office

  • Enrollment, waiver, and general assistance
  • Referrals for services in the Hanover, NH area
    • Medical Services call: Primary care and Women's Health (603) 646-9401
    • Mental Health Services call: Counseling Department (603) 646-9442

Resource Documents

These documents are available to help you compare health plans and make a coverage decision that's right for you.