Harvard University Health Services

Massachusetts QSHIP Requirements

114.6 CMR: DIVISION OF HEALTH CARE FINANCE AND POLICY

114.6 CMR 3.00: STUDENT HEALTH INSURANCE PROGRAM

Section 3.05: Waiver of Participation Due to Comparable Coverage


(1) Election of Waiver of Participation. An institution of higher education may elect to allow full-time and part-time students to waive participation in a qualifying student health insurance program. The institution must require students waiving participation to (1) certify, in writing, at least annually, as part of the institution’s usual registration process that they are participating in a health benefit plan with comparable coverage and (2) to provide documentation of such coverage.

(2) Comparable Coverage.

(a) Coverage under a health benefit plan is comparable if

1. the health benefit plan provides to the student throughout the school year reasonably comprehensive coverage of health services, including preventive and primary care, emergency services, surgical services, hospitalization benefits, ambulatory patient services, and mental health services; and

2. the services covered under the health benefit plan are reasonably accessible to the student in the area where the student attends school.

(b) An institution of higher education may waive participation for students enrolled in MassHealth.

(c) An institution of higher education may not waive participation for

1. students determined to be Low Income Patients for Services Eligible for Payment from the Uncompensated Care Pool; or

2. students with coverage from insurance carriers outside the U.S. and coverage by foreign National Health Service programs, unless the student is studying in a foreign country and the student’s insurance provides coverage in that location; and

3. students with a health insurance plan that provides coverage through a closed network of providers, not reasonably accessible in the area where the student attends school, for all but emergency services.

(d) It is the responsibility of the student seeking to waive participation in a qualifying student health insurance program – not the institution of higher education in which the student is enrolled – to determine whether the student’s health benefit plan has coverage comparable to the coverage offered under a qualifying student health insurance program.

For more information call 1-800-888-2250 or e-mail studenthealth.help@state.ma.us.