We will issue medical insurance waivers to enrolled undergraduates who have an insurance plan outside of the Anthem Blue Cross coverage negotiated by the College. To receive a waiver you must complete the online medical insurance waiver application by September 10, 2014. 

We have developed a set of questions that students must answer as they complete the insurance waiver application.  Please be sure to answer them carefully and completely.  Please contact the Health and Wellness Center if you have any questions. 

Requirements  

  1. I will be a full time enrolled UNDERGRADUATE student at Saint Mary's College at any time during the 2014-2015 academic year.
  2. My primary residence is in the United States.
  3. My plan is provided by a company licensed to do business in the United States, with a U.S. claims payment office and a U.S. phone number.
  4. My plan covers inpatient and outpatient medical care within 50 miles of campus.(Emergency or Urgent only coverage does not satisfy this requirement).
  5. My plan covers inpatient and outpatient mental health care within 50 miles of campus. (Emergency or Urgent only coverage does not satisfy this requirement).
  6. My plan is currently active and I agree to maintain health insurance coverage throughout the entire 2014-2015 academic year.
  7. I acknowledge that I am responsible for payment of all fees for medical and mental health treatment not covered by my health insurance plan (including but not limited to deductibles, copays, coinsurance and the expenses above my policy maximums and benefit limits).
  8. I can provide proof of insurance upon request.
 

To complete your application, you will need: 

  • Name of your insurance company
  • Your policy number/member number
  • Your company's customer service phone Number (back of your ID card)

Online Insurance Waiver Application

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Saint Mary's College of California
1928 Saint Mary's Road
Moraga, CA 94575
(925) 631-4000
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