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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.


Terms and Conditions

Do you want to submit online applications? Before completing an online form and submitting the application, please read and agree to the following terms and conditions.

Submission of an online form indicates:
  • an understanding that it is solely the responsibility of the student whose name and identification number (The Student) is on the form to ensure that the form has been received by the benefit office/representative;
  • an understanding that the information provided is required in order fulfill the purpose of the form;
  • authorization and consent to the use, release and exchange of said information between the educational institution, the student organization, the plan broker, third party service providers and the insurance company(s) to be used solely in connection with the administration of the Student Benefits Plan;
  • confirmation that all the information provided is accurate; and
  • that additional terms as indicated below by type of form also apply.
Falsification of any information provided by The Student is considered to be a serious form of fraud.

OPT-OUT FORM: The Student wishes to decline the student International health and/or dental plan(s) coverage. Comparable International health and/or dental coverage are presently provided for the student under another insurance plan. The Student understands that s/he would have been able to claim under his/her existing insurance as well as under the student health and/or dental plan(s), thereby increasing coverage.

The Student acknowledges that as a result of the opt-out, s/he forfeits all rights to coverage otherwise available to him/her under the student health and/or dental plan(s). The Student realizes that s/he will not be able to rejoin the plan(s) until the policy anniversary or unless s/he ceases to be covered by the insurance used to opt-out of the student health and/or dental plan(s) and apply within 30 days of losing said coverage. The Student must complete the necessary form, pay any fees associated in rejoining the plan(s) and provide the necessary proof of loss of insurance in order to reinstate coverage.

OPT-OUT DEADLINE: The opt-out deadline dates are established by the Institution. You will not be able to opt-out of coverage at any other point during the school year. For example, if your program starts in September, you must opt-out prior to the end of the Fall deadline. The same rule applies for opting in (unless you lose your comparable coverage, see below for loss of coverage information). NO EXCEPTIONS will be made if the deadline is missed. It is The Student's responsibility to pay the plan fees, should they miss the applicable opt-out deadline.

OPT-OUT EMAIL CONFIRMATION: You will receive a reply email confirmation after you complete and submit the online opt-out. Please retain a copy of the email confirmation for your records. The email confirmation is your ONLY proof that you applied to opt-out of the coverage.

ONLINE OPT-OUT AUDIT: You may be asked to provide documentation of your existing coverage at any time throughout each year of coverage. Documentation must show the name of the insurance company providing coverage and the policy number. Acceptable documentation may be an insurance policy, a photocopy of the policy provision page/schedule of benefits, a benefits booklet, a statement of claim, or a membership card. Without such documentation you will be reinstated to the mandatory benefit plan and assessed the applicable fee.

After the initial Opt-Out Form is processed, the Student is automatically opted-out each consecutive school year s/he attends the institution.

FAMILY ENROLMENT FORM: The Student understands that the information provided above is required to provide the same dental and/or extended health benefits received as a student to spouse and/or dependent(s). The Student has the authority to provide such information and authorizes the use of the information provided where it is required in the administration of the insurance benefits. The Student understands that in order to receive coverage for an eligible spouse or dependent(s) the appropriate fee must be paid. The Student agrees to pay the appropriate fees for the coverage requested prior to the applicable deadline.

The Student confirms that the individual(s) for whom coverage is being requested qualify based on the eligible definitions of spouse or dependent.

Definition of Spouse: Spouse means the person who is a resident of Canada, and who is married to The Student, or a person of either sex who has continuously co-habitated with The Student for a period of at least 12 months and who is publicly represented as The Student's wife or husband.

Definition of Dependent(s): Dependent means an unmarried child who is a resident of Canada, and entirely dependent on The Student for maintenance and support, and who is:
1) under 21 years of age,
2) under 25 years of age and attending a college or university full-time, or
3) physically or mentally incapable of self-support and became incapable to that extent while entirely dependent on The Student for maintenance and support and while eligible under 1) or 2) above.

Your family can only be covered while you are a student on the plan(s).The Student understands that the coverage provided to the plans will need to be renewed each Benefit Year. FAMILY ADD-ON FEES ARE NON-REFUNDABLE.

Family Enrolment is not guaranteed by submitting this form; the applicant must be eligible for the program and the appropriate fees must be paid.

Booth UC Benefits Plan Office

Address: 447 Webb Place
Winnipeg, Manitoba. R3B 2P2

General Inquiries Line

Monday to Friday from 7:00am to 6:00pm CST

Phone: 1-877-746-5566 Ext. 7249