Discrimination and the Impact on International Students

April 7th, 2021 by Sally McLeod

One year after the initial shutdowns of colleges and universities across the United States, mental health and the impact on international students has been widely discussed and looked at across the international student community. Studies have shown that college-age students in the 18-24 year old range have been hit the hardest by the pandemic in terms of the highest rates of depression and thoughts of suicide. The more particularly vulnerable populations of international students in this age group have been forced to deal with additional obstacles and challenges. With travel bans and new measures on maintaining visa status implemented at the start of the pandemic, along with navigating a new normal of quarantine and isolation in a foreign country away from friends and family, it’s no question that stress and anxiety have been at all time highs. International students from China, which are noted for being the largest population demographic studying in the United States for the last 15 years, have faced even more difficulties with heightened scrutiny and racism throughout the pandemic. 

Anti-Asian Racism in the United States 

International Students of Asian descent, particularly those from China, have dealt with stigmas and discrimination in the United States prior to the pandemic due to a number of factors related to political and trade tensions, along with alleged security threats. However, this past year has exceeded others by far with an increase in anti-Asian hate crimes by nearly 150% and an increased 833% of anti-Asian attacks in New York City. The suspected rise stems from xenophobic rhetoric perpetuated through various platforms, thought to exacerbate notions of linking a place or a people to disease, in addition to the resurfacing of negative sterotypes on Chinese culture and traditions. In a recent study, 26% of Asian-American adults across the US said they feared being threatened or physically attacked because of their race, which is a higher percentage than Black, Hispanic or white adults. One of the latest shooting massacres in Atlanta that killed eight people, among which six were Asians, by a white gunman, has only heightened anxiety and fear amongst those of Asian descent and highlights the importance of creating racial justice and solidarity. 

Looking at the Numbers 

According to the most recent Open Doors report, China remained the top country of origin for international students across the US in the 2019-2020 academic year. However, this increase was significantly smaller compared to years past and more notable was a smaller rise of .8% for those willing to host the 372,532 Chinese students. It will be interesting to see how the recent events from this past year reflect numbers going forward of this demographic and what this means for the US economy, as international students contributed over $44 billion dollars to the US in 2019 with over $15 billion from Chinese students. 

Creating Solidarity

With a rise in hate crimes against minorities, along with the countless deaths of those such as Ahmaud Arbery, Breonna Taylor and George Floyd taking on a movement of its own this past year, social justice is at the forefront of our society and can no longer be ignored. Just as hate and racism can spread quickly through the media, so can reform. This could be viewed as the silver lining, as light is shed on the injustices and voices are being heard. NYU’s Office of Global Inclusion denounced anti-Asian racism in April of 2020, but recently issued a statement on February 16th communicating their solidarity with the Asian, Asian American and Pacific Islander (AAPI) communities encouraging students to attend various university and student-led virtual events promoting inclusion and understanding. Many universities have followed suit. After UC Berkeley’s apology for listing xenophobia under ‘common reactions’ to coronavirus in early 2020, the University, along with others, have since created AAPI support groups along with easy and accessible ways to report incendences of hate, violence, discrimination and harassment. Other organizations are making efforts to raise awareness as well, such as the Massachusetts General Hospital Center for Cross-Cultural Student Emotional Wellness creating an annual conference for professionals dedicated to support the wellbeing of Asian and Asian American students. 

International Students in the Future 

The new White House Administration is already taking steps to revoke travel bans and reform restrictive policies impacting international students, in addition to strengthening relationships and creating strong ties allowing for shared information across foreign governments. The initiatives are not going unnoticed, and the volume of applications for international students is up! According to numbers from the Common App, international student college applications have increased by 9 percent as of January 22, 2021 from the year prior. With the lifting of travel bans and other visa restrictions in conjunction with COVID-19 vaccines becoming more available worldwide, it’s hopeful that these numbers will continue to climb. While this is all good news, what’s also notable is that the number of applications from China is down by 18%. The US has a lot of work ahead in terms of continuing to create a place of peace and unity for all. It’s the hope that through education, continued discussion and programming that change can be made and all voices are heard. 


Leah Campbell “Adults Under 24: The Loneliest Age Group During COVID-19 Restrictions” 2020. [online] Healthline.com. Available at: https://www.healthline.com/health-news/adults-under-24-the-loneliest-age-group-during-covid-19-restrictions [Accessed 29 March 2021]

Tiffany Hsu “Anti-Asian Harassment Is Surging” 2021. [online] nytimes.com. Available at: https://www.nytimes.com/2020/07/21/business/media/asian-american-harassment-ad-council.html [Accessed 29 March 2021]

Mei Lamison “University community responds to surge in anti-Asian racism” 2021. [online] nyunews.com. Available at: https://nyunews.com/news/2021/03/15/anti-asian-hate-crimes-covid [Accessed 30 March 2021]

Viggo Stacey “Open Doors: fall survey suggests new starts down 43%” 2020. [online] thepienews.com. Available at: https://thepienews.com/news/us-sees-first-drop-intl-student-numbers-in-15-years-as-covid-adds-pressure/ [Accessed 30 March 2021]

Lei Zhang and Erika Lee “Anti-Asian Xeneophobia” 2020. [online] unm.edu. Available at: https://immigrantcovid.umn.edu/anti-asian-xenophobia [Accessed 29 March 2021]

The Open Doors Report on International Exchange 2020. [online] opendoorsdata.org. Available at: https://opendoorsdata.org/annual-release/

Report: US introduces restrictions for some Chinese visas. 2018. [online] icef.com. Available at: https://monitor.icef.com/2018/05/report-us-introduces-restrictions-for-some-chinese-visas/ [Accessed 30 March 2021]

Service Standards at ISI

March 2nd, 2021 by Yessica Pacheco

Have you ever called a service line, like your internet provider or your cell phone service, and when you hung up the phone, you were smiling because the person on the other end of the line was prompt and empathetic? Customer service can truly make or break a company. Word of mouth travels faster than any means of communication, and in the age of technology, it’s easy to find online reviews detailing one’s opinions or experiences with a particular business. 

At ISI, we pride ourselves on having the best customer service in the industry. This wouldn’t be possible without our clients, both individual and group! Our customer service representatives go through an intensive training program to ensure they provide the best information to you and your students. As the customer service manager at ISI, my experience of moving to the United States from Colombia and the struggles I went through have inspired me to help others in their international education journey and share my experience with my team. So what kind of training does our customer service team go through? And what can your students expect when contacting us? 

Here is a look behind the scenes:

Licensed Insurance Experts

All of our customer service representatives go through the state’s licensing process to obtain their insurance licenses. Insurance in the US is regulated at the state level, for this reason you must be licensed to sell health insurance in the state where you reside. Not all companies invest in their customer service representatives to have an insurance license but we are committed to providing our representatives with additional certifications to ensure they are informed and educated. Going through the insurance class allows our representatives to learn the concepts and terminology of health insurance in depth. It ensures that we will provide our clients with the most accurate information in a way they will understand.

International Education and Industry Knowledge

Higher education can be as complex as the US healthcare system. At ISI, we want our team to be educated not only about insurance, but the specific needs of students or scholars learning abroad. We encourage our team to attend many conferences throughout the international education industry, like NAFSA and ICEF, so they can understand the unique needs these students have and the challenges that face them. We also create presentations on relevant topics to our international community and develop free resources and trainings to help you discuss these subjects with your students.

Empathy and Professionalism

Our insurance representatives are trained to listen to each and every one of our clients. Every international student, scholar, and traveler has their own unique story, and we want to understand their individual needs. We value empathy to really understand the unique needs and help them find the plan and address any additional help they may need. Our clients can be assured that when they contact us, the person on the other end of the line will take ownership of their case and empower them to answer any questions or solve any problems they may encounter.

Immigration and Policy Updates

International students have to learn how to navigate a wide range of immigration policies when planning their studies abroad. We are in constant communication with experts in the industry to stay up to date with the latest regulations. Pandemic or not, we are staying updated on travel warnings from the US Department of State and the CDC, so your students know if and when it’s safe to travel, and that your students are covered no matter where their travels take them.

Cultural Sensitivity

ISI is headquartered in Neptune Beach, FL, US. However, we have three international offices located in Xiamen, China, Mexico City, Mexico, and Leipzig, Germany. Our team includes members from different countries and backgrounds that speak multiple languages and can relate to someone traveling abroad. Like myself, all of our representatives have studied or lived abroad at some point in their lives, allowing them to put themselves in our clients’ shoes.

Ongoing Trainings

Quality assurance is at the top of our list; our Trustpilot is a true testament to the quality of service we promise our clients. Our representatives have quarterly reviews where they listen to their phone calls from past experiences and review emails and interactions with past customers to help them improve their communication and effectiveness. Additionally, we have monthly training sessions to improve our overall knowledge of the products we serve and enhance our professional skills. 

Our customer service representatives can help your students in many ways. Whether it is providing a visa letter for an appointment at the embassy or helping to find providers in-network near their home, our team at ISI will always ensure that you and your students receive the best experience possible when you contact us!

We’re here to help you and your international students. Our hours of operation are Monday – Friday, 8am to 6pm EST.

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Look Back 2020, Plan Ahead 2021

January 5th, 2021 by Elaine Del Rossi

The international education system witnessed a chaotic start of 2020 due to the COVID-19 pandemic. It created the most considerable historical education system disruption, affecting almost 1.6 billion learners from over 190 countries on all continents (United Nations, 2020, 2). While each education level is undergoing unique challenges, the higher education segment might trigger an international learning revolution—one that we are seeing in this country now.

The greatest challenge in international higher education was the loss of learning. The introduction of online learning was a way of rescuing the situation and preventing the academic year’s loss. This was a new experience for some institutions, and the transition from campus study was not easy for most students but especially international students. Higher education institutions in industrialized nations had the resources to transition to online learning smoothly, but those in developed countries struggled to cope. Approximately 40% of those nations failed to support learners during the pandemic (United Nations, 2020, 8). Similarly, many international students could not access learning materials because they lacked equipment and internet.

The international higher education system has been shaken to the core during 2020, and this can be the catalyst for changes in education models. Blended in-person and online education can be expected to continue globally from next year. Campus-based higher learning institutions are likely to adapt to new technological approaches to learning. Likewise, resilient and efficient technology-based education systems capable of withstanding the drawbacks of pandemics will develop. Changes will range from pedagogy, tools and assessment methods, learning outcomes to and educational investment. Additionally, the move towards a profit-making private education sector in most nations will continue to aggravate higher education inequalities (“Higher Education, International Issues,” 2020, 1). Most deserving candidates will miss enrollment opportunities since they cannot afford the escalating costs of higher education. There is the possibility that broader public goals and traditional universities’ functions such as academic freedom and autonomy will be ignored (“Higher Education, International Issues,” 2020, 1). The adverse economic impact of 2020 and higher education costs will also lead to many students not being able or deciding not to attend college thereby making other education/career choices.

A major area of disruption has been education abroad. Before the current crisis, the number of U.S. students studying abroad was growing according to Education Dynamics. During the 2017-2018 academic year, the number of study abroad students grew by 9,000 to a total of 341,751. However, the pandemic caused unprecedented disruptions to study abroad programs over the past year, with colleges and program providers evacuating students from their host countries in large numbers and suspending most international programs for the summer and fall. Some colleges have extended existing restrictions on university-sponsored study abroad travel through next spring, while others are evaluating programs on a case-by-case basis. (Inside Higher Ed, 2020). And there doesn’t seem to be any light at the end of that tunnel. Many schools have stated to offer virtual study abroad programs. Virtual Study Abroad experiences are an innovative way to reach more students and faculty, as well as further promote traditional study abroad. These virtual study abroad opportunities have far fewer limits and are accessible to all. Virtual study abroad experiences will continue to develop, diversify, and evolve into the future while going hand in hand with existing programs. While it is not the intention that virtual study abroad replace traditional programs, rather they are another avenue for students to participate in the international experience.   

2020 has been a challenging year for international higher education. There has been a loss of learning, and educational inequalities have also exacerbated. It seems like these issues will extend beyond the pandemic, and most disadvantaged learners will lose opportunities in higher education institutions. It is also expected, in 2021, that new resilient and technology-based education systems will emerge and that heart of the coming transformation of higher education is technology. Gap years might also become more attractive in 2021. It is no secret that most 18-year olds are not quite ready to assume the rigor of college and a gap year might afford them the opportunity to expand their experiences and gain the maturity necessary for college life. Ninety percent of kids who defer and take a gap year return to college and are more likely to graduate with better grades. (Post Corona: From Crisis to Opportunity). Virtual study abroad will also be more available and allow these experiences to many more students who prior could not afford the cost or time away due to family or work situations. With the arrival of new vaccines for COVID-19, it is hopeful that international student enrollments will resume to a “normal” level in the Fall. There are serious challenges for 2021 but this new year also presents many opportunities for growth and introducing new and exciting changes.


  • Inside Higher Education: November 19, 2020.

The Additional Stressors Covid Brought and Its Impact on the Mental Health of International Students

December 1st, 2020 by Jennifer Frankel

Covid-19 has changed the landscape of education across the globe, and nowhere has that been more apparent than within international education. One of the major impacts has been on the emotional wellbeing of international students, where the American College Health Association found that international students have been disproportionately impacted by this global pandemic. 

In the past, international students have struggled with their mental health at higher rates than domestic students, and this was understandable given the additional challenges international students faced when it comes to learning a new language, adjusting to a new culture, adapting to a new educational system, being far away from their safety net, and being in a new country. With the introduction of Covid earlier this year, however, the stressors were exacerbated and international students were particularly vulnerable.

The COVID Stressors

What made Covid so unique was that it wasn’t an isolated event. It wasn’t geographically limited. It wasn’t a local problem – it was a pandemic that spread across the globe hitting some places harder than others, but almost everyone – no matter where they were – were affected.

Students, no matter what country they were from, were concerned about their families back home, their health and access to care locally, their education and the form it would take, and their relationships from family to friends to teachers to peers. Let’s take a few of these issues to explore their impact.

Immigration and Visa Issues

Covid is a particularly contagious virus, spreading quickly through populations in close contact. Countries had to respond, and many of those responses had to do with travel. It meant shutting down airports, closing down embassies, canceling flights, and restricting entry. Students had to decide – and quickly! – whether they would continue to stay abroad or return home. There was no guarantee that if they went home, they would be able to return to continue their studies. There was also uncertainty about what constituted meeting the requirements of a valid student visa – would online classes be acceptable? What about hybrid learning? And even if you did go home, what would learning be like online? There were so many questions, and some questions still remain unanswered today. But one thing is certain, all of this created so much uncertainty, stress, and anxiety about what to do and what the future might look like.


Many schools abruptly canceled their classes and told students that they should not plan to return to school after spring break. While this would cause panic for any student who had grown accustomed to their independence in dorms and college living, it particularly impacted international students who may have had very little back up options. Some students were able to find alternative accommodations such as living with family members who may have been local – or perhaps living in a different state. In NAFSA’s Brief on International Students at Community Colleges, they found that students at community colleges were particularly impacted since they were less likely to offer on-campus housing and students were not only distanced by the transition to online classes, but “international students may find themselves challenged by suddenly distanced – physically, socially, and emotionally – from their college campuses.” Not only do we see that housing was uncertain for many, but that students were being isolated from all parts of life and this was validated by a number of surveys done on college campuses which reported barriers to making friends and feelings of loneliness.


Another top struggle international students have placed as a top stressor during the pandemic has been their finances. People around the world have lost their jobs or have become unable to work, and this happened in record numbers. Many of these international students were relying on those very incomes to help cover a very expensive education. In other cases, students who had on-campus or off-campus jobs were suddenly unemployed and their extra income had disappeared. One way to gain insight is that some college campuses have seen a rise in economic hardship requests going up and some schools are taking a hard look at the costs to see what they can do – but there isn’t much as many of these schools are also strapped facing tuition concessions, staff furloughs and layoffs, COVID protection programs, etc.

Online Learning

Online learning has been both a struggle and a blessing for many, oftentimes it depends on where the student is located and what access they have. For any of us who have taken an online class, we can all attest that it is a very different experience from an in-person class, and requires a sense of focus that is otherwise instilled in an in-person learning environment. Many international students have struggled, especially those who have returned home, to find that they are having to take a class at 11 pm local time, and it can be hard to bring your A-game when you are already so tired. Then, there is of course, the access of having reliable internet connection that can support many of the technologies that schools are using to deliver their education. It can be difficult to participate if you do not have a reliable connection, if you don’t have a quiet place to learn away from distractions, and you don’t have all the equipment you need to make sure you are able to engage in the expected manner. Online learning has also impacted the way international students engage and make friends. Remember that study from 2012 about the difficulties international students had making American friends? This has been more challenging than ever. Many international students would show up to class, and rely on the classroom interactions to start making friends with their peers. Now, making friends in an online setting has become much more difficult – and for many, even more isolating.

Health & Insurance

Many international students were concerned about their health and what impact Covid might have on them, and they of course were not alone. But when you are in a foreign country, it can be all the more scary. Does your insurance plan cover Covid testing and if you get sick? Where do you go if you get sick? Where can you get testing, how much does it cost, and do you have access to a testing center? There were many, many questions that we had from students wondering what to do if they got sick, where to go, and whether their insurance plans cover them. There was also a lot of health information coming out, but as we were learning more about the virus, the recommendations continued to change. All of the changes, including how you can contract the virus, whether or not to wear a mask, where you should or shouldn’t go – all of this kept creating fear and uncertainty.


We also saw an uptick in “discrimination and isolation” according to the Lancet, where “some media outlets have used derogatory headlines, perpetuating stereotypes, and prejudices about Chinese people.” I spoke to one advisor who said that a Chinese student came into the office and said that she just wanted to let them know that she didn’t have Covid, just in case they were wondering. 

Dealing with all that Stress

All of these stressors, and still others not mentioned above, continue to contribute to the stress our international students are experiencing. While every international student experiences different stressors and may handle stress differently, some studies are finding increases in depression and anxiety. Based on a poll conducted in March by Inside Higher Ed, “more than 90% of presidents reported being very or somewhat concerned about COVID-19’s impact on student mental health.” And the numbers coming out continue to support and justify this concern.

Based on these struggles it is important that students have access to mental health counseling, and many of these resources are available on college campuses. While keeping up with demand can be difficult, it is important to have multiple ways for students to access care. Having an insurance plan that includes mental health coverage can also provide more options to students who may be unable to access counseling services on campus or would like additional options. And beyond that, telecounseling has become embraced during the pandemic as a means to get confidential counseling over the phone, by chat, or through video without leaving home – some also include language support for international students who prefer to speak in their native language. 

It is important to note, however, that stigma around mental health continues to persist globally, and finding creative ways to reach students who may not be inclined to use these services continues to be critical. Finding ways to connect students, create community, to check-in, and find ways to help students find a healthy life balance is also key to efforts in reaching students and encouraging resilience. 

For additional student resources, be sure to check out and share our Emotional Wellness During the COVID-19 Outbreak page and our latest videos of how international students are dealing with Covid. You can also access our free emotional & mental health training program online. 

The Parties At Work: Understanding Your Insurance Plan

November 5th, 2020 by Sally McLeod

Health insurance in the United States can be complicated and confusing, especially since there are many parties involved in making sure that your plan runs smoothly and seamlessly. In this blog, we are going to explore who these parties are, what they do, and how they work together to provide care for your students in the event they need medical care.

What is an insurance company?

The insurance company also referred to as the insurer, assumes the risk of an insured. The insurance company creates a quote, sells the policy, provides coverage, and pays out the claim. The “insurance company” is a general way to refer to insurance, but depending on your plan structure, there can be many additional parties listed under this umbrella that we will explain below.

What is a third party administrator (TPA) or plan administrator?

Insurance companies can also outsource various duties to a third party administrator (TPA). A TPA is an organization which can assist in managing an insurance plan. They can be responsible for the underwriting which includes pricing and plan design. They may also be instrumental in providing customer service for their members, and process the claims in-house.

What is the insurance plan’s network?

A provider network is a list of contracted doctors, hospitals and clinics that members can go to for medical treatment. Because of the contract in place with these providers, they often offer discounted rates, direct payment and ease of claim filing. Insurance companies may have their own network or they may also contract a separate network for their members to use.

Who is the assistance company and what do they do?

Insurance companies may also work with an assistance company that provides emergency transportation and arrangements in case a crisis occurs. While this may be a service offered in-house by the insurance companies or TPAs, in many cases the insurance company will use an outside company that has worldwide relationships to coordinate care around the world.

Who is the underwriter?

The underwriter is a separate organization that insures and spreads out the risk that the insurance company is taking on. Insurance plans are typically backed by an insurance carrier that will help cover the expenses in case the insurance company is unable to pay. Examples include Sirius International and Lloyd’s of London, and it’s important to verify their ratings through third parties such as AM Best and Standard and Poors.

What does a broker do?

The responsibility of a broker is to understand the health insurance needs of their clients and work with the insurance companies to provide adequate coverage. A broker’s role is to offer guidance and outline the various pros and cons of potential plan options, so that informed decisions can be made, along with having an extra layer of support for those insured on a plan. 

Depending on the insurance plan, there may be multiple parties at play. Before signing an insurance contract, it is important to understand how the insurance is set up, who the parties are involved, and how they all work together.

If you are looking for health insurance, ISI is an insurance broker that has been a trusted industry leader since 2001. ISI specializes in international students offering both group and individual plan options. Learn more about us

Fall Semester Recap

October 29th, 2020 by Elaine Del Rossi

This year, so far, has been a transformational one for higher education. Many colleges and universities have decided to offer only remote, virtual programs; offer a hybrid of virtual and in-person; have opened completely only to move to virtual programs in light of COVID-19 infections among students who returned to campus. For those on campus, students and faculty are being asked to perform a daily health screening and are required to wear face coverings. Schools are also attempting to limit large social gatherings of students as that seems to be the nexus of where the contagion spreads.

COVID-19 presents unique challenges for colleges and universities. It has rewritten how they offer education; safety services and preserve their financial health. And the end is not in sight. A recurrence is beginning in most parts of the country and the most apparent decision schools must keep their campuses safe is to close/continue online programs throughout the Fall.

As discussed in September 11 article of Inside Higher Ed:

While the country continues to battle the coronavirus, college health professionals are also monitoring a growing crisis among young adults struggling with mental health problems, including suicidal ideation, anxiety and depression related to the pandemic. Several recent surveys of students suggest their mental well-being has been devastated by the pandemic’s social and economic consequences, as well as the continued uncertainty about their college education and post college careers. Still reeling from the emergency closures of campuses across the country during the spring semester and the sudden shifts to online instruction, students are now worried about the fall semester and whether campuses that reopened for in-person instruction can remain open as COVID-19 infections spread among students and panicked college administrators quickly shift gears and send students who’d recently arrived back home.”

Student mental health has always presented challenges for colleges and the COVID-19 pandemic situation has increased the awareness of this issue. A way to address some of the issues that students are struggling with is telehealth and teletherapy which have become quite prevalent during COVID-19. Not only does this provide almost immediate access to care, but it also provides the confidentiality that most college students want when attempting to deal with mental health issues.

All of this is occurring with a backdrop of overall decreasing college enrollments which is not solely the cause of COVID-19. The numbers of college age students in the US have been steadily dropping over the last 10 years and institutions must look elsewhere to fill those gaps. The best way is to recruit more international students and from areas other than the traditional locations—China and India. And to do that, recruiters need to adopt a more international lens to recruitment.

One of the best ways to help ensure the health, attraction and retention of students is with a health benefit program that align/addresses the needs of both the students and the school. COVID-19 has presented many health challenges and it is imperative that benefit programs offered to students reflect and align with the current needs. Does the program cover all COVID-19 related health issues? Does it offer coverage for pre-existing conditions? Is adequate coverage for mental health included and does it offer Telehealth benefits? With all the pandemic issues and regulations facing schools today, it is important that they can design benefit programs that meet all the needs of the institution as well as those of their students.

In this ever-changing landscape of healthcare, delivering benefits that are comprehensive; competitively priced and supported with a concierge-level of customer service takes experience, expertise and a singular focus and commitment to and a full understanding of the international student and business travel market.

International Student Insurance believes that one-size doesn’t fit all. We work with our clients to understand their insurance/risk objectives and develop tailored programs that best fit their needs and those of their students and/or business travelers. 

Behind the Scenes: Why So Much Information is Asked to Get a Quote

September 29th, 2020 by Jennifer Frankel

Now is the time when many schools are looking to evaluate their group insurance options. There is often a lot of confusion about the process and what you actually need to provide to get a new quote. You may ask yourself, why are they asking for my current brochure? Why do they need to know the cost of my plan, shouldn’t they be able to tell me what the price is? Or, you may be wondering why they are requesting a copy of your group’s claim history and if this is necessary information to share. In this blog, we hope to provide some clarity and transparency about what information is useful, why it is requested, and how it will impact the proposal you receive.

Initial Discussion

Whether you are speaking directly with the insurance company or a broker, you will likely be asked many questions after expressing interest in getting an insurance plan quote. Commonly asked questions include:

  • How many students do you have?
  • What are their ages?
  • What is the average length of stay?
  • What type of visas are they on?
  • Can you provide your insurance brochure and current price? 
  • Proposed plan design if different from in-place plan
  • What is your renewal rate?
  • Can you provide your claims history for the last 3 years?
  • Will your plan be mandated? If there is a waiver, who can waive and under what circumstances?

This may seem like a lot of questions, but each of these questions are important from an underwriter’s perspective to appropriately evaluate a plan and provide a realistic price. 

Demographic Information

As you can imagine, the age, length of coverage, and number of students you have on your plan can all impact the rate of your plan. Some insurance carriers may even ask if you know the gender breakdown of students and how many dependents (if your group plan covers dependents) you will have on your plan.

Because of the impact of demographics, an insurance company may ask for a census of your currently enrolled students to get an idea of the overall age distribution of your student population. Let’s examine each one individually.


Not surprisingly, students who are older tend to have more medical issues and thus a higher utilization compared to younger students. Because of this, the older your student or scholar population, the more expensive your insurance plan will be.

Length of Coverage

Students who are on the insurance plan for a short time will typically have less claims than if they are on the plan for multiple years. Most international students are typically in the US for 2-6 years, and thus most international student insurance plans may already account for this.

Number of Students

The larger your student body, the more premium will be generated to cover claims, and it would be more likely that if there is a high-dollar claim, your plan will still have a solid loss ratio (meaning that the generated premium will be able to cover the cost of the claims).


Many group insurance plans are not extending coverage to spouses or children, and a big reason for this is because of how expensive it can be to add them. If family coverage is provided on the group plan, there is typically a separate rate that will apply to them (and it is oftentimes more expensive). 


Other questions are often asked about where students are from, where they need coverage, and the type of visas they are on. This is often asked for two reasons. The first is to confirm eligibility of all participants. Especially when you are evaluating an international student or study abroad plan, the carrier will need to confirm that students are outside their home country and may also need to verify that they are traveling for educational purposes. 

Secondly, the insurance company will also need to know where students will be traveling to. Costs across the United States and abroad vary quite extensively, so many underwriters will want to know the cost of medical treatment in that area to correctly rate the plan. 

Requested Documentation

While you might think that the demographic information is enough to get a quote, additional documentation can help the underwriter both design the plan more appropriately based on your needs as well as guide the correct pricing of your plan.


While not always required, your existing group brochure is a good guide to see what your current benefits are, and for them to see what the pricing was based on. It can also be a good place to start as you can take what you have and make further modifications. If there is no existing group plan in place, you may be asked specific benefit questions so that the insurance proposal will reflect the benefits you and your students need.

Current Pricing, Renewal Rate, and Claims History

Stability is the key to a successful insurance plan, no one wants a cheap plan only to find out that at renewal, the rate will jump dramatically. This is why current pricing is requested, why the renewal rate is helpful, and why your claims history is requested. These can help dictate a trend, and more than that, it can also help reduce your rate.

Example. Let’s suppose you have an older population of students that need insurance coverage. Based on their age, you may get a high rate. But, let’s say that you have had very little claims over the past few years. In this case, the insurance carrier may be able to offer you a more competitive rate based on your claims history. 

And why 3 years of claims? Three years can help determine a trend and will help to offset any outliers that you may have had.

Underwriters use all of this information to generate a competitive quote. If you do not share this information, then the underwriter will typically use their existing book of business to determine what the rate should be, and will make any necessary adjustments at the time of renewal. Depending on the underwriter, this will typically be a more conservative approach and can mean a higher price than what you would have had if more information was provided. The alternative can mean that you get a low price but that your rate will have to be adjusted at renewal, and thus you might have an unexpected rate increase at renewal.


The final piece to getting a quote is how your plan will be administered. Many underwriters will want to know whether everyone will be required to purchase the plan, or if students will be able to waive and purchase alternative coverage. If they are able to waive, they will want to know the circumstances in which a student can waive. 

The reason for this has to do with adverse selection. Oftentimes, school insurance plans are more comprehensive than what a student would purchase individually. If a student has the option to waive, the market has found that healthier students may choose to opt out of the school’s insurance plan and buy individually since they think they are healthy and may not need to use the insurance. Those who choose to stay on the school’s insurance plan tend to need a more comprehensive insurance plan for medical care.

Because of this, having a mandated group plan helps to reduce adverse selection and provide a more stabilized insurance plan, which could result in a better rate on the plan.

Group Quote

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Back to School

September 4th, 2020 by Elaine Del Rossi

As students and faculty make decisions about returning to campuses this Fall, many bring with them concerns-mainly health safety and financial. Many families have faced financial hardships and money that was earmarked for student’s college education, in many cases, have been diverted to support or supplement basic everyday needs. Many students for either safety or financial reasons have decided to either defer the Fall semester or elected to attend a state school or community college.

Colleges have also faced a large number of challenges and decisions regarding whether or not to resume in-person classes; virtual classes or a combination of both. Some colleges, Notre Dame, University of North Carolina Chapel Hill and Georgetown University for example, have announced that they had to rethink their plans for in-person classes. Many schools are only permitting certain cohorts back to the campus. The Chronicle and Davidson College recently published a reopening model that indicate the national breakdown as:

  • TBD                                                           24%
  • Primarily in-person                                19%
  • Hybrid                                                      16%
  • Fully online                                                6%
  • Fully in-person                                       2.3%
  • Other                                                          6%

Any of these models are very expensive choices and none of them represent “business as usual” models. Many of them represent loss of revenue for the school in addition to the cost of health and safety processes that need to be in place. Some of the schools we have spoken with indicate that they are experiencing losses ranging from $83 million to over $100 million. Schools are also establishing additional resources to handle the needs of students who are attempting to cope with all the changes and isolation. According to a new survey by TimelyMD, an overwhelming majority (85%) of college students say they continue to experience increased stress and/or anxiety as a result of COVID-19.

Many students have also expressed concerns regarding their readiness to have a college experience that was fully or mainly online. Also, many students from families struggling to meet financial obligations may not have the appropriate technology that will allow them to be successful in a virtual environment. One way schools have attempted to “level the playing field” is to ensure that each student has the tools necessary to successfully access online classes. As an example, Rutgers University recently sent students Apple iPads to make certain they were ready to begin virtual classes.

For many students, having some or a majority of classes online doesn’t present much of an adjustment. Many have grown up with the technology and are quite familiar and proficient with it. What has become somewhat of a major issue with many students is the way in which their lives have been disrupted. Some students have or may experience social or emotional impacts that these life changes have created. Students are typically social animals and the restrictions that COVID-19 has presented can be emotionally upending for some. For most of them, what they are experiencing now is not the life that they were expecting. In an article in the Chronicle Review, David Rosowsky, a professor from the University of Vermont, suggests “More than ever before, students will be thirsting for belonging, for feeling secure and confident, and for the knowledge that people are looking out for them”.

At this point, it is difficult to determine the full impact of all this on students and higher educational institutions. What can be done is provide the students will tools and services that will best address their medical, social and emotional needs. Even though classes may be virtual, many student health centers continue to offer counseling services.

Medical Debt: Helping Your International Students

September 2nd, 2020 by Yessica Pacheco

Healthcare became the topic of almost every conversation overnight thanks to the current pandemic. In the US, it brought up painful reminders about the health and safety of the international community and the healthcare system as a whole. 

As someone living in the US, medical debt is not uncommon. In fact, according to a study done by Health Affairs in 2018, one in six people in the US have past-due medical bills. Imagine now if one of your international students, that may not speak English fluently, came to you with astronomical medical bills. Unpaid medical bills create a great deal of anxiety for anyone, especially when you’re not familiar with the medical system in a foreign country. The US healthcare system is very complex and very expensive. 

If your students are being contacted by hospitals or collections agencies, there are ways to help them and guide them. Here are some ways to deal with medical debt:

Gather the information

It might seem like detective work, but it’s important to cross all t’s and dot all i’s so you are able to advise your students correctly. Is your student insured? If so, did they file a claim with their insurance company? Are the bills they are receiving their out-of-pocket expenses or have the claims not been processed yet? Were claims denied? 

If an international student is uninsured, you’ll want to gather all of the bills that they’ve incurred and the contact information for all providers. Gathering all of the information will help your student with the next step. 

Options Available

Many hospitals and providers in the United States have a financial assistance policy or charity care policy in place. In fact, by law, nonprofit hospitals are required to have these assistance policies. Contact the billing office at these places and inquire about possible options:

  • The provider might agree to reduce the bill
  • The provider might offer a payment plan 
  • The provider could forgive the entirety of the debt if the student is able to provide proof that they are not able to pay for their medical expenses

Persistence is the name of the game. You or your student should open a channel of communication between you and the provider. Explain the situation, use words like “financial hardship”, “no sources of income”, and listen to the options they give you.

The Negotiation Phase

Much like a realtor does when helping you purchase a house, you can also negotiate medical bills. To our surprise, not many people know this. If your student is uninsured, a hospital will charge him or her based on their chargemaster rate, or the full sticker price if you will. It’s important to do some research and find out how much the hospital would bill an insurance company, Medicaid or Medicare. Insurance companies remind their clients often to use their contracted providers and there is a reason for it. They have already negotiated how much a hospital can charge their members. 

Useful Resources

Like the insurance company, when you or your student are trying to negotiate medical debt, ask for the lower price. You might find the Healthcare Bluebook helpful as it provides fair pricing for medical procedures. This will give you an idea on what pricing you can ask for.

Another useful resource once you or your student have exhausted all negotiations with the hospital is to bring in an expert. The National Foundation for Credit Counseling can pair you with a credit counselor and help you navigate medical debt with a medical provider or a collections agency. They offer assistance in English and Spanish which might be useful for many international students. 

When it comes to tackling medical debt, your international student is not alone. You can refer them to our student blog on How to Deal with Medical Debt in the US for more information. We also offer many free resources for you and your international community like our educational videos about the intricacies of the US healthcare system available in eight different languages.  


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