The Student Health Insurance Plan corrected its exclusion clause Thursday night after realizing expenses acquired from self-inflicted injury were not covered under the plan.
According to SHIP’s exclusion clause before the change, “expense incurred as a result of suicide or attempted suicide; or intentionally self-inflicted illness or injury” was not covered by the health insurance plan.
University Health Services Executive Director Sarah Van Orman said during the 2008-09 year, many changes were administered to SHIP, including the addition of a mental health parity. SHIP was extended to cover all mental health services on the same terms as medical services.
According to Van Orman, it was SHIP’s intention to have self-inflicted injuries covered under the plan.
Van Orman said until Thursday when The Badger Herald contacted officials inquiring about the exclusion she was not aware it was still in place.
“We thought it had been removed,” Van Orman said. “We are very concerned about it and very sorry it happened. It was not intended to be on the plan’s [exclusion] document.”
Van Orman said she contacted Maksin Management Corporation, SHIP’s claims administrator, Thursday afternoon requesting the exclusion be removed, effective immediately.
Maksin is also adjudicating SHIP’s records over the past two years to make sure no claim of self-inflicted injury was denied based on the oversight, she added.
If Maksin finds a member was denied coverage, SHIP will take on the expense of the incident, said Richard Simpson, manager of SHIP.
SHIP members will still be required to pay co-payments and deductibles for treatment of self-inflicted injuries, Simpson added. A national member is subject to pay up to $250 per year in deductibles and a 20 percent member co-insurance for in-network health care; an international student is only responsible for a 10 percent member co-insurance.
The exclusion clause is standard to many individual health insurance plans, Van Orman added. Under the Health Insurance Portability and Accountability Act, SHIP is classified as an individual health plan. Therefore, including coverage for self-inflicted wounds in not mandatory like it is for a group health insurance plan.
“We value our plan and pride ourselves on having very few limitations,” Simpson said. “This is something we [wanted] to do. Exclusions like this should not apply to SHIP.”