Information for St Olaf students covered under the Accident & Sickness Plan:
Plan Overview
Plan Benefits: The following expenses will be paid, after the deductible, at 80% of the preferred allowance for Network Providers and 60% of usual &
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Additional plan details are available in the plan brochure at: www.cirstudenthealth.com/stolaf
Claim Procedures in the event of an injury or sickness:
- Print an identification card if you have not received one from the health insurance company.
- Report to the Health Services so that proper treatment can be prescribed.
- If away from campus, or if Health Services is closed, consult a physician.
- ACI must be notified within 30 days after the date of the injury or illness.
- A claim form MUST be completed in full and signed.
- Send the claim form within 90 days from the date of injury or illness.
Prescriptions:
After a co-payment of $10.00 for generic or $20.00 for a brand name drug per prescription, the cost of
prescription drugs is paid in full, up to a maximum of $500.00 per condition. Prescriptions must be filled at a participating pharmacy. To find a participating pharmacy, visit www.medco.com or call 800-400-0136. Students will be given an insurance ID card to show to the pharmacy as proof of coverage.
Claim procedures to receive reimbursement for prescriptions:
- You must pay for your prescription at the time of purchase.
- A claim form MUST be completed in full and signed.
- Send the form along with the receipt within 90 days.
- Retain a copy of all information for your records.
Deductible:
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What is a deductible?
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Cost - The annual premium is $856.00 for coverage from Aug. 15, 2011 to Aug. 14, 2012. |
Visit www.CIRStudentHealth.com/stolaf or call the Student Insurance Program administrator at 1-800-322-9901 -
- To view complete information about the plan including claims forms, provider network, replacement cards, and more
- Get answers to Frequently Asked Questions
- To contact us with specific questions

