Benefits

GAIP eligibility and coverage overview

Academic student employees (ASEs) receive health insurance through the Graduate Appointee Insurance Program (GAIP). GAIP covers medical, vision, and dental care for teaching assistants, research assistants, tutors, predoctoral researchers, and other ASEs working across the University.

GAIP benefits are negotiated between the UW and United Auto Workers on a three-year basis. The benefits are administered by LifeWise, a health insurance company based in the Pacific Northwest.

Eligibility

The UW pays for your GAIP coverage if you hold an eligible job appointment and meet all these requirements:

  • You enroll for at least 10 credits during the quarter
  • You’re position is at least 50% full-time equivalent
  • You’re paid on at least five of the six pay days of the coverage period
  • You register for classes by the 10th day of each quarter

This eligibility criteria applies to the fall, winter, and spring quarters. If you remain eligible throughout these three quarters, you’ll automatically receive summer quarter coverage.

To see a list of job appointments that are eligible for GAIP coverage, visit the departmental information page.

Fellows and trainees with stipends

Fellows and trainees holding an eligible job appointment receive UW-paid GAIP coverage if all the following apply:

  • You enroll for at least 10 credits per quarter
  • You’re paid at least $800 per month
  • You’re paid on at least five of the six pay days of the coverage period
  • You register for classes by the 10th day of each quarter

This eligibility criteria applies to the fall, winter, and spring quarters. If you remain eligible throughout these three quarters, you’ll automatically receive summer quarter coverage.

To see a list of job appointments that are eligible for GAIP coverage, visit the departmental information page.

Self-pay option

If you aren’t eligible for UW-paid GAIP coverage, you may be eligible for the self-pay option, which allows you to pay out of pocket for coverage.

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Enrollment

You don’t need to enroll yourself in GAIP. Instead, your eligibility is established when your department enters your employment information into the payroll system. However, to avoid any coverage delays, you should contact your department and verify your employment information was entered into UW Payroll if you haven’t received enrollment confirmation.

Once enrolled, you’ll receive an enrollment confirmation email from LifeWise, the plan administrator. Please make sure to read all the GAIP information you receive as it contains important information about the GAIP plan.

Enroll a dependent

Your LifeWise enrollment confirmation email contains instructions for making changes to your dependent coverage. See the deadlines, costs, and other details on the dependent coverage page.

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Coverage and costs

Your GAIP health plan is administered by LifeWise Assurance Company. To learn about your coverage, including how much you’ll pay for certain services, visit their website. There you can review the plan benefit booklet, which explains your coverage in detail. The site also features a search tool if you’d like to see which doctors and pharmacies are in the plan’s network.

For questions about coverage, claims, eligibility, and enrollment, contact LifeWise.

When coverage starts and ends

Once enrolled in GAIP, you’re covered on a month-by-month basis for the duration of your job appointment. Your coverage starts on the first day of the quarterly coverage period (these don’t correspond to the academic quarters). The coverage periods are:

  • Fall: October 1 to December 31
  • Winter: January 1 to March 31
  • Spring: April 1 to June 30
  • Summer: July 1 to September 30

If your job appointment begins after the first work day of the period, your coverage will begin on the first day of the next month. For example if your appointment begins October 15, your coverage begins November 1.

Your coverage ends at the end of the month that your job appointment ends. If needed, you can continue your coverage, either through the self-pay option or the continuation of coverage provision.

Your insurance card

You’ll receive your GAIP insurance card shortly after you’re initially enrolled. If you need a temporary card before yours arrives, visit the LifeWise website to download a temporary card. At the website, you can also request a replacement for a lost card.

Coverage summaries

Review these for a quick overview of your GAIP coverage:

Mail-order prescription drugs

Drugs prescribed by your physician that you take on a regular basis and which are determined to be eligible by LifeWise Assurance Company, are available at a discounted co-pay through Rubenstein Pharmacy at Hall Health. The mail order option uses the same formulary list as the regular Rubenstein prescription plan, but offers the convenience of delivery by mail. More information about the mail order prescription drug plan is found in the Prescription Drug / Pharmacy Plan.

To order prescriptions, first read and agree to the Hall Health mail-order agreement for GAIP (PDF), then complete the GAIP Mail Order Patient Registration (PDF) form. The pharmacy will also need the following to process a mail order request and subsequent refills:

  • Original prescription
  • Current mailing address and daytime phone number
  • Credit information (if applicable)

Prescriptions must be dropped off in person or mailed in to Rubenstein Pharmacy. Mail order prescriptions must be paid for by debit or credit. Checks of any kind will not be accepted for mail order prescriptions. Patients should allow 7 to 10 working days after the pharmacy receives the prescription for the drugs to arrive via U.S. Mail. If an alternate means of delivery is required or requested, an additional shipping and handling fee may apply.

Rubenstein Pharmacy reserves the right to contact the prescribing physician to confirm the need for maintenance medication and the right to verify future GAIP eligibility.

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How GAIP medical benefits work

The Graduate Appointee Insurance Program is a Preferred Provider Plan (PPO) which means you may visit any medical provider you wish, however costs will vary depending on the following:

  • Whether you are:
    • An academic student employee (ASE) who is registered for UW classes,
    • An ASE who is not registered for UW classes, or
    • An ASE’s dependent
  • And whether you choose an:
    • In-network provider
    • Non-network provider

The term “provider” refers to individuals who provide care, such as a physician or nurse practitioner or the facility you use when you receive care, such as a hospital or clinic.

In-network providers are contracted by the plan administrator, LifeWise, to reimburse at a discounted rate. Non-network providers on the other hand are not contracted by LifeWise and therefore may bill you for charges over the allowable charge.

Hall Health primary care center

Medical services that you receive from in-network providers will be reimbursed at higher levels than non-network providers, however the highest level of benefits will come from using Hall Health Primary Care Center, the Plan’s preferred In-network provider.

Hall Health offers the following resources to ASEs (enrolled in UW classes) and their dependents:

  • Primary & Family Care
  • Mental Health Clinic (for individual and group therapy)
  • Women’s Health
  • Rubenstein Pharmacy (for prescription drugs)
  • Sports Medicine
  • Travel and Immunization Clinics
  • Urgent Medical Advice
  • Health Promotion/ Wellness Resource Center

Note: For Hall Health Services not available to you, these will be indicated by “NA” in your medical plan summary (below).

For more information, pick up a detailed brochure from Hall Health Center or contact Hall Health.

Providers available to Academic Student Employees

If you are an ASE who is registered in UW classes, you will have three levels of coverage available to you depending on the type of provider you choose:

  • Preferred In-Network Provider: Hall Health*
  • In-Network providers
  • Non-Network providers

*ASEs who use Hall Health services do not have to meet a deductible and the plan covers 100% of most covered charges up to an individual maximum of $1,000 each plan year. (Services that meet the federal preventive guidelines do not accrue to this maximum.) Hall Health services provided beyond the $1,000 individual maximum will be subject to the in-network level deductible and plan limits.

Review the medical benefit coverage summaries for more details about the benefit levels for each type of provider.

Providers available to dependents and non-registered ASEs

ASE dependents as well as ASEs who are not registered for classes have two levels of coverage available to them, depending on the type of provider they choose:

  • In-Network providers (this includes Hall Health)
  • Non-Network providers

Benefits at Hall Health are covered at in-network levels and generally subject to the deductible.

Review the Summary of Medical Benefits for Dependents & and non-ASEs (PDF) for more details about the benefit levels for each type of provider.

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Coordinating benefits with other plans

If you’re enrolled in another health plan, you cannot cancel your GAIP coverage. Instead, you will have to coordinate the benefits provided by the two plans. In most cases GAIP will be your primary plan unless you enrolled in another employer plan first. Learn more about coordination of benefits by visiting the LifeWise website and downloading the plan benefit booklet.

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Medicare credible coverage notice

Is the GAIP plan that is offered considered credible for prescriptions by Medicare? LifeWise Assurance Company has determined that the prescription drug coverage offered by your health plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered “Credible Coverage.” Because your existing coverage is Credible Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. View the Medicare credible coverage notice (PDF).

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