COURTESY OF GLOBAL TRANSITION
A change to Fordham’s health insurance policy now requires students to purchase Affordable Care Act (ACA)-compliant insurance. This requirement has disrupted international students’ plans for attaining the health care waiver and using their own preferred insurance plan.
International students are not generally subject to the ACA as it is a U.S. federal law. Non-residents, including international students or scholars with F, J, Q, or M visas do not need to obtain coverage that is compliant with the ACA standards. However, since Fordham added compliance with the ACA to their own requirements, international students are now subject to the same standards issued in the ACA.
International students were notified of the change to Fordham’s student health insurance policy last spring. However, many assumed it would not affect them because a popular health insurance, UnitedHealthcare, is based in the U.S., qualifying it for ACA approval.
“The only difference we had was we bought it through a broker, not directly from United Healthcare itself, so it turned out to be for international students only,” Levy Li, Graduate School of Arts and Sciences (GSAS) at Rose Hill ’21 and an international student from China, said. Purchasing through a broker meant that it wouldn’t be compliant with the ACA since it is considered not underwritten in — or financed by — the U.S.
“I can guess that the broker who provides the Aetna plan does not want to see many international students waive their plans.” Zifan Li, GSAS ’21
According to Li, their health insurance was approved by the university-issued health insurance company, Aetna, which qualified them for the waiver. The waiver allows students to use their own insurance and refunds all fees from the university health care. Fordham students are given a deadline to submit the appropriate information on the plan’s webpage to either register for the university health insurance or waive the fees by showing they have their own insurance. This year, the deadline was Sept. 10.
Shortly after the students had received the confirmation from Aetna’s webpage, they were informed by Maritza Rivera-Garcia, the health insurance compliance administrator, that their insurance plan did not meet the university’s new requirements.
Li said that he and a few other international students emailed Rivera-Garcia for clarity on why their insurance does not qualify for the waiver. “However, we did not receive any positive feedback, and her response did not justify the reason specifically,” he said.
Consequently, Li and 48 other international students signed a petition requesting the university consider students’ reasons for choosing the health insurance that best suits them, removes the requirement for health insurance to be underwritten in the U.S. and take “a more proactive role in school health insurance contract negotiations with brokers and insurance companies.”
Zifan Li, GSAS ’21 and an international student from China, wrote the petition letter. He said that his plan has been accepted by the insurance department in the past few years prior to the mandatory compliance with the ACA, therefore it was proved to satisfy the other waiver requirements.
“I can guess that the broker who provides the Aetna plan does not want to see many international students waive their plans,” he said.
The signers of the petition prefer their choice in health care because it suits their medical and financial situations better than the university health insurance. The cost of Aetna is $3,401 per year, whereas UnitedHealthcare is much less expensive. Levy Li’s plan only costs $1,200 for the year and Zifan Li’s costs $1,290.
Not only does UnitedHealthcare have a lower premium, but it also has a higher reimbursement rate, no deductible and includes vision coverage; Aetna has no vision benefits and a higher out-of-pocket payment if the coverage exceeds the limits.
Additionally, there is a $150 administrative fee to Fordham if students purchase the student health insurance. This fee funds medical services and resources on campus, including tests and vaccines, according to Gregory J. Pappas, assistant vice president for student affairs.
The UnitedHealthcare student insurance is able to provide comprehensive benefits at a lower cost because it is designed with a younger, healthier population in mind and for a limited time, according to their website.
On Sept. 3 at 10 a.m., the petition was emailed to Fordham President Rev. Joseph M. McShane, S.J., Vice Chairs of the Board Don Almeida and Mary Anne Sullivan, Vice President Martha K. Hirst, and the Office of International Services.
“The insurance department feels that the Aetna plan is the best plan, however, we feel that our plan is the best plan with equal or higher benefits & coverage, and we can prove this.” Levy Li, GSAS at Rose Hill ’21
The students requested that their issues in the petition be resolved one week before the waiver deadline, Sept. 10; however, this did not happen. After the petition was submitted, Levy Li received an email back from Pappas. Later in the week, Pappas acknowledged the petition and agreed to schedule a town hall meeting for all international students and administrators to attend in order to answer further questions. The date for the town hall has not yet been established.
In the meantime, international students were required to drop their purchased health care plans and enroll in Aetna. Some students received a full refund from their health insurance company, but others who have already used benefits from their coverage had to absorb the prorated cost of their plan in addition to the university health insurance fee.
In his emails to Pappas, Levy Li routinely asked for a reason why Fordham denied their health care plan, since this plan had been approved in the past.
“The insurance department feels that the Aetna plan is the best plan, however, we feel that our plan is the best plan with equal or higher benefits & coverage, and we can prove this,” Levy Li said in an email to Pappas.
Pappas responded that the university has found that students with less expensive plans end up paying more annually in the long run. Therefore, by issuing a requirement that all Fordham-alternate health insurance plans be compliant with ACA, it aims to guarantee that all Fordham students will be subject to the same changes and coverage. ACA, Pappas said, has the “most universally-available and clearly-defined levels of adequate medical coverage” in the area.
While both our domestic and international student populations are subject to the same insurance requirements, internationals may experience more difficulty obtaining alternate insurance.” Maritza Rivera-Garcia, health insurance compliance administrator
On Fordham’s health insurance website, it is listed that for international students seeking alternative health care plans, their plan must meet the following criteria: It must maintain insurance coverage equal to or greater than the university-issued insurance with no additional exclusions, the insurance company must be headquartered and operated in the U.S. with a claims office also in the U.S., the plan must be compliant with ACA which includes inpatient hospitalization and outpatient benefits in NYC, and the maximum benefit payable under the plan must be unlimited.
UnitedHealthcare meets all of these requirements, except for that it was not underwritten in the U.S. and thus not compliant with ACA.
“We take this as a very serious issue,” Levy Li said. He explained that domestic students can waive Fordham insurance by using a family plan or employer-sponsored plan, but there is a disparity for international students who cannot default to a U.S.-issued plan. “We don’t have family here, and 99% of the international students do not have insurance sponsored by an employer at this time.”
The university admitted to this imbalance in an email from Rivera-Garcia: “While both our domestic and international student populations are subject to the same insurance requirements, internationals may experience more difficulty obtaining alternate insurance than their domestic classmates.”
Pappas later addressed that Rivera-Garcia will be available to meet and discuss alternate non-Fordham health insurance plans with the international students that are ACA-compliant as well as affordable.
“If the administration is unable to solve this, I will feel disappointed,” Zifan Li said. “If they did not take any proper actions, I would begin to suspect how Fordham provides a Jesuit educational experience to all students.”
Kat Ehring contributed additional reporting to this article.