Below you will find useful information about the
Evergreen Valley College
International Student Insurance Plan
Helpful Quick Links
Use your insurance
On-campus health services
Visit the campus health center first before receiving any treatment off campus.
Location: Student Services Center, Room SC 124
Phone: (408) 270-6480
Monday – Thursday: 8:00 a.m. – 5:00 p.m.
Friday: 8:00 a.m. – 3:00 p.m. (Closed 11:30 a.m. – 12:30 p.m.)
Closed weekends and school holidays. Consult the campus health center website for summer hours.
Find plan documents here
How to search for an
If you are unable to visit the campus health center, use providers in the PPO network whenever possible.
It is best to locate an in-network doctor, urgent care center, and emergency room near you before you get sick. To find a PPO provider, visit the Aetna Passport website (link below).
- Visit www.aetna.com/docfind/custom/passport.
- Enter your location and range, then click “Search.”
- Select the Passport to Healthcare® Primary PPO, then click “Continue.”
- Type the name, specialty, or type of provider you’re looking for into the search bar, or click the corresponding category.
- Select a provider from the list, and call to make an appointment.
Always check with the doctor or medical facility directly to confirm that they accept the Aetna Network before you receive treatment.
Pharmacy benefits are managed by Express Scripts. Express Scripts pharmacies include CVS, Walgreens, and Walmart. Please see the Express Scripts website (link below) to find a pharmacy near you, or call (800) 400-0136.
To fill a prescription, visit any Express Scripts pharmacy and pay the copay. If you visit a non-network provider, it will not be covered by the plan.
Get your medical bills paid
If your provider files the claim on your behalf:
- The claims administrator still requires certain information from you. You will need to fill out a form indicating whether or not you have other insurance coverage. You will need to do this only once per academic year. You can find the Other Insurance Coverage Form below.
- You will receive an Explanation of Benefits (EOB) that outlines what the insurance company paid and what is your responsibility to pay, if applicable. The claims administrator will contact you if they need other information; otherwise, they will pay the claim as indicated on the EOB. Do not ignore calls or letters from the claims administrator, as this may delay payment of your claim.
If the provider does not file a claim directly with the insurance company on your behalf, you will need to submit a claim for reimbursement for the portion of the charges the company is responsible for paying by completing these steps:
- Download a claim form below and fill it out completely.
- Include your policy number (as shown on your ID card) on the claim form.
- Attach bills for X-rays, lab charges, etc.
- Send your claim form and all bills pertaining to this claim to Administrative Concepts, Inc. at the address below. Try to have all itemized bills attached to the same claim form.
Administrative Concepts, Inc.
PO Box 4000
Collegeville, Pennsylvania 19426
Fax: (610) 293-9299
Keep copies of all the documents you submit for claims. If you have questions about claims, contact Administrative Concepts, Inc. at (800) 483-6192 or email@example.com.
Confidential Communication Request
If you would like to have confidential medical information from the claims administrator sent to an address other than the address on file with your school, you can download a Confidential Communication Request, fill out the form, and send it to the address listed. This form is available below.
When traveling away from
your school or outside the U.S.
Students covered under the student insurance plan are automatically enrolled in the Scholastic Emergency Services (SES) coverage. SES offers many services to help students when traveling away from your school or outside the U.S., including medical emergencies during travel, help with lost luggage, documents, or medications, insightful pre-trip information, and more.
For additional information, see your plan brochure or visit the SES website.