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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 re-enrolled? Eligible Students may submit their online forms.

Submitting Online Applications

Before submitting your online forms, please review the eligibility criteria and read the Terms and Conditions.

The online forms for Fall have closed

Calendar The Fall deadline was October 5th, 2022

The following online forms are not available at this time:

  • Health & Dental Opt-Out
  • Health & Dental Family Add-on
  • Health & Dental Flex your Plan

Winter 2023 forms available in December. Deadline to submit for winter eligible students is February 8th, 2023. If you were eligible for the plan for the first time in the Spring-Summer or Fall term and missed the deadline, your application will be denied.

Opt-Out Application

If you are covered by a comparable Health and Dental Plan from parents, spouse, work, government, or band and do not wish to Coordinate Benefits, you may submit an online Opt-Out application.

Flex your Plan Application

Suit your Health and Dental needs by choosing one of the three flex your plan options at no additional charges.

Family Add-On Application

Extend your plan to your dependents and provide the same protection you have. Additional charges that must be paid using a credit card.

Re-enroll Application

If you previously opted out of the plan and have lost your comparable coverage or a lifestyle change occurred, you may re-enroll into the Student Plan.

Winter Deadline to submit applications