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  dollar sign  Student Hospitalization Insurance

    *Student Health Insurance – Important Information*

The Patient Protection Affordable Care Act will establish insurance market places for each State. 

The State of NJ Department of Banking and Insurance provides some basic information to help you select an appropriate individual or family health insurance plan at the following links:

If you need coverage prior to January 1, 2014 the following websites will allow you to obtain quotes for an individual health plan:

The following site will allow individuals beginning October 1, 2013 to sign up for health coverage that will take effect January 1, 2014.   


   dollar sign  Student Hospitalization Insurance Claim Form - for Spring 2013 semester and prior semesters only (full-time or part-time students) 

To submit a claim, print out the claim form linked below, complete it in full and return it to the Plan Administrator (listed at the top left side of the form) WITHIN 90 DAYS from the date of treatment along with all itemized bills received to date.  Please be sure to follow all instructions on the form.

Student Insurance Claim Form(.pdf)
(must be PRINTED and filled out; this is not an online form)

Full-Time Student Insurance Plan Brochure AY 12-13

Part-Time Student Insurance Plan Brochure AY 12-13

dollar sign Student Insurance Website - for Spring 2013 semester and prior semesters only (full-time or part-time students)

On this website maintained by Commercial Travelers  (http://www.studentplanscenter.com), students also have access to the following:

  • Agent of Record- Contact Information for TL Groseclose
  • Brochures- FT and PT Student Accident & Sickness Insurance brochures in PDF
  • Find a Provider- find Devon Health providers
  • Forms- The following forms can be accessed:
    • Authorization to release Personal Health Information (PHI) - The student claimant completes and provides this release to the third party administrator to authorize access to more medical information from a medical provider to adjudicate a claim.
    • Privacy Notice- to inform student how the carrier handles private information.
    • Claim Form
    • Permission to Disclose Health Plan Information- Allows the third party administrator to work with other individuals on behalf of the claimant (such as a parent).
    • Frequently Asked Questions (FAQ)
    • Logon/View Claims Status- Students can check the status of their Accident & Sickness claims.

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