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Student Health & Wellness!mystudentplan is a benefits plan for students and can provide coverage for prescription drugs, vision care, dental care, mental health counseling, and more. The plan is designed to supplement provincial health insurance and provide additional access to medical services.

 

Online Forms

Are you covered by a comparable plan? Do you wish to cover your dependents? Or have you opted out of the plan and wish to be re-enrolled? Eligible Students may submit their online forms.

Health and Dental Family Add-On Application

Winter deadline to submit applications
January 26th, 2024

Eligible students who meet the following eligibility criteria may apply by the applicable deadline to extend their coverage to their dependents.

Health and Dental insurance fees on the student account are for the student only. Students must apply and pay additional fees to have their family members added.

Eligibility Criteria

There are 2 circumstances for adding family members to the Student Health and Dental Plan:

1 Academic Enrollment

Eligible students who wish to extend their benefits to their dependents may apply in fall or winter enrollment:

  • Fall Enrollment: Eligible students may apply to add their dependents to the benefit plan before the fall deadline.
    If you are enrolled in fall term and miss the fall deadline, the next opportunity to add family members will be next fall.
  • Winter Enrollment: Only new students or returning eligible students who have not attended the fall term may apply to add their dependents by the winter deadline.
    If you are enrolled to start your studies in winter term and miss the winter deadline, the next opportunity to add family members would be next fall.
2 Lifestyle Change

Students enrolled in the plan who have a lifestyle change such as getting married, meeting the twelve-month co-habitation requirement for common law status, or birth/adoption of a child who wish to extend their plan to their dependents may apply within 30 days of lifestyle change.

To apply, please email proof of Lifestyle Change to the Benefit Plan Office at boothplan@mystudentplan.ca. If you are eligible to add family members, the office will send a link for the application.

Documentation includes a marriage certificate, birth certificate, or adoption documents.

Health and Dental Plan Family Add-On Fees:

ONE FAMILY MEMBER TWO OR MORE FAMILY MEMBERS
Health $158.00 Health $158.00
Dental $160.00 Dental $320.00
Health & Dental $318.00 Health & Dental $478.00

International Emergency Health Insurance Plan Family Add-On Fees:

ONE FAMILY MEMBER TWO OR MORE FAMILY MEMBERS
Emergency Health Insurance $785.00 Emergency Health Insurance $1,250.00

International students are required to purchase the International student emergency plan coverage for their dependents in order to purchase extended health benefits for their dependents.

Health and Dental Plan and International Emergency Health Insurance Plan Family Add-On Fees:

ONE FAMILY MEMBER TWO OR MORE FAMILY MEMBERS
Health $143.00 Health $143.00
Dental $160.00 Dental $320.00
Emergency Health Insurance $785.00 Emergency Health Insurance $1,250.00
Emergency Health Insurance and Health $928.00 Emergency Health Insurance and Health $1,393.00
Emergency Health Insurance and Dental $945.00 Emergency Health Insurance and Dental $1,570.00
Emergency Health Insurance and Health & Dental $1,088.00 Emergency Health Insurance and Health & Dental $1,513.00
  • These are the current International Emergency Health Insurance Plan and extended Health and Dental Plan Family Add-on fees. However, the fees are subject to change without notice.
  • These fees are not included in your tuition, and you will pay them with a credit card on our website if your application is approved.
  • The Family Add-on fees cover 12 months of coverage.
  • Health and Dental Plan or International Emergency Health Insurance Plan Family Add-On Fees are non-refundable.
  • If you are not able to pay the additional fees by visa or master card, please email us at boothplan@mystudentplan.ca to make arrangements to pay by debit or personal cheque.
Important notes:
  • You can only extend your plan to your spouse or partner and your children. Parents, grandparents, and siblings are not eligible dependents to extend your plan. Please check the eligible dependents.
  • Your family will have the same coverage as the student. The student and the family member do not share the coverage.
  • The family fees provide coverage for one year. The student needs to keep active in the plan for 12 months. If the student loses the coverage, the family loses the coverage too. The effective date of your coverage would be the 1st day of the month when the term begins.
  • In order for international students to add their dependents to the Health & Dental Plans, they must be added to the Emergency Health Insurance Plan first.
  • Family Add-On requests & fees are not automatically renewed and must be submitted/paid every year.
  • There is a 45-60-day validation period from the start of the program. During this time, you would have to pay out of pocket for all eligible Health and Dental expenses and keep the receipts. After the enrollment process is complete, you will be able to submit online claims for reimbursement and your Plan Card will be automatically activated.
  • Each family member uses the same card that the student has. The card must have the student's information (full name and student ID).
  • The fees for Family Add-ons are non-refundable.
  • NO EXCEPTIONS will be made if the application or payment is missed. It is the student's responsibility to check their emails regarding the application.
  • Once you complete the Family add-on form, you will receive an automated email confirmation. Please keep this email for your records as it is your only proof of submitting a Family Add-on request.

Steps to submitting your Family Add-On:

1 Student Information
Complete this section below providing true and correct information. Click NEXT.
2 Dependent Information
Scroll down and check Spouse/Child/Children according to the members you wish to add. Provide full name, initials, gender, and date of birth for each member. Click NEXT.
3 Read and Agree to the Terms and Conditions
Click on the checkbox to indicate that you agree to the Terms and Conditions agreement. Click SUBMIT to finish your application.
4 Confirmation Email
Check your email and verify if you have received the confirmation email. If you do not receive this email, you must resubmit the form.
5 Application Status
You will receive an email with the status of your application.
6 Pay Fees Online
If your application is approved, you will receive a link to pay the applicable fees with your credit card and the deadline to pay them.

Add donotreply@gallivan.ca to your address book. Please do not reply to this email.

Questions? Please contact your Benefit Plan Office: boothplan@mystudentplan.ca

Health and Dental Family Add-On Form

Please complete all information on the family add-on form and we will process your application as soon as we can.



Student Information

Sex
Date of Birth
Phone Number
Program Start Date