Student health insurance
Students who are enrolled half-time or more on the Lacey campus are
required to have health insurance coverage. Students who have their own
coverage must submit an online waiver form directly to the University's
health insurance provider by the first day of the semester. Waivers are
good for the academic year provided that the coverage listed has not
For information regarding the University's student health insurance
plan, please see the Summary of Benefits and Coverage document at
http://studentinsurance.wellsfargo.com/ or by contacting Wells Fargo
Insurance Services at (800) 853-5899.
Plan costs and coverage dates
||8/25/14 - 1/12/15
||1/12/15 - 8/25/15
||5/19/15 - 8/25/15
|Per child only
Note: Costs for spouse and children are in addition to
the student premium.
Health Insurance waiver form
Students are required to submit the online health insurance waiver form
by the first day of the term. If the waiver has been accepted, the insurance
charge will be removed from the student's account within approximately three
business days. If the waiver is denied, the student will have the
opportunity to appeal the request directly online.
International waiver form
All international students are required to have health insurance
coverage. International students must contact the Office of International
Programs 360-438-4375 for more information.
The completed form must be received in the Office of International
Programs by the first day of the semester to be valid for that enrollment
For more information regarding the University's insurance coverage
through First Choice Health, click
www.fchn.com or call 800-467-5281.
Claim forms are processed through AG Administrators and can be found at
To process your claim please submit the following pieces of
- Completed and signed claim form (if applicable - see
- Itemized bills
- Explanation of benefits from your primary insurance
These documents should be mailed or faxed to:
A-G Administrators, Inc.
P.O. Box 979
Valley Forge, PA 19482
610-933-0800 Phone 800-634-8628 Toll free
Claim form - This is not required for a sickness claim, but is required
for all accident claims. However, if a claim form is not submitted and the
adjuster needs additional information regarding a sickness claim he or she
may request it to be completed and submitted.
Itemized Bill - Please include copies of all medical bills, showing the
name and address of the provider of service, date of service, type of
service and the charges. Account statements or "balance due" statements are
helpful, but do not contain all the information needed to process the
Explanation of Benefits (If Applicable) - If you have other medical
insurance, all medical bills must be first submitted to that carrier for
their determination of eligibility. If the charges are not paid in full by
the other medical insurance carrier we will need to see a copy of the
"Explanation of Benefits" from that carrier prior to issuing benefits from
this office. If you have no primary medical insurance the need for an
"Explanation of Benefits" will not be applicable to your claim.