UCLA Visiting Scholar Injury and Sickness Insurance PlanGarnett-Powers & Associates Celebrates Over 25 Years of Excellence in Benefit Solutions

UCLA Visiting Scholar Injury and Sickness Insurance Plan

Garnett-Powers & Associates (GPA) is pleased to offer the UCLA Visiting Scholar Benefit Plan.

GPA is the broker/administrator for these plans and has been retained by UCLA to oversee the enrollment, payment and waiver process for the program.

Your Medical Plan Choices

Domestic (U.S. Citizens or U.S. Permanent Residents) Scholars/Students have only one plan available to choose from, Plan A: the UnitedHealthcare/Student Resources (UHCSR) Plan.

International Scholars/Students have three medical plans from which to choose: Plan A: the UnitedHealthcare/Student Resources (UHCSR) Plan; Plan B: The IMG Standard Plan; or Plan C: the IMG Platinum Plan.

Please note that once you have completed your enrollment into the plan of your choice, you will not be able to change plans until the new plan year which starts September 1, 2016. There are no refunds for any of the plans. So please be sure to review the premiums and benefits fully before choosing.

Please view the medical plan/rate comparison chart below to help you choose the medical plan that best suits your coverage needs.

Highlights of Coverages
(Showing In-Network Benefits Only)
Plan A
UnitedHealthcare Student Plan
Plan B
IMG Standard Plan
Plan C
IMG Platinum Plan
Maximum Limit None $500,000 Student / $100,000 Dependent $1,000,000 Student / $100,000 Dependent
Per Illness/Injury Maximum Unlimited $300,000 Student / $100,000 Dependent $500,000 Student / $100,000 Dependent
Deductible $250 per policy year $100 Per Illness/Injury $25 Per Illness/Injury
Maternity 20% 80% up to maximum limit
(only covered if pregnancy is conceived during period of plan coverage)
$25 Copay
(only covered if pregnancy is conceived during period of plan coverage)
Prescription Drugs $20, $40, $80 Copay 50% of Actual Charges 50% of Actual Charges
Evacuation Unlimited $500,000 $500,000
Repatriation of Remains Unlimited $50,000 $50,000
Pre-Existing Conditions Waiting Period None 12 months 6 months
Meets the J Visa Requirements Yes Yes Yes
Affordable Care Act (ACA) Plan Yes No No
Premium Quarterly Premium Monthly Premium (Age Rated) Monthly Premium (Age Rated)
Visiting Scholar or Student $1,034 19–23 years old – $93
24–30 years old – $104
31–40 years old – $171
41–50 years old – $267
51–64 years old – $353
19–23 years old – $132
24–30 years old – $150
31–40 years old – $252
41–50 years old – $407
51–64 years old – $543
Spouse $1,034 19–23 years old – $346
24–30 years old – $382
31–40 years old – $508
41–50 years old – $524
51–64 years old – $508
19–23 years old – $487
24–30 years old – $538
31–40 years old – $716
41–50 years old – $740
51–64 years old – $716
Child(ren) One Child – $1,034
Two or more Children – $2,068
0–18 years old – $88 0–18 years old – $117
Spouse plus two or more children $3,102 Not Applicable Not Applicable
  ENROLL ENROLL ENROLL

You may view the plan information in more detail by clicking on one of the following links:

Waiving the Plan

As a Visiting Scholar on the UCLA campus, you are required to have medical insurance that meets the waiver requirements. The waiver requirements also apply to your eligible dependents.

You have the option of enrolling in Plan A, B or C to obtain the appropriate level of coverage approved by UCLA. Or you may choose to waive (decline) coverage by purchasing your own medical insurance that meets the waiver requirements. To waive out of the UCLA Visiting Scholar Benefit Plan please view and follow the instructions on the Waiver Form listed below:

UCLA Waiver Form