Student Health and Wellness

Group number: 166175
Certificate Number: Student ID
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Call Centre: 1-866-586-1010
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Student Health and Wellness! mystudentplan provides health, prescriptions, dental, mental health care plus additional benefits for eligible students.

Family Add-On Applications

Submit your health and/or dental family add-on application before the deadline.

Fall Application Period

August 1^st to September 20^th, 2025

Make sure to submit your form by September 20^th as the online form won't be accessible after that date.

Your student account fees only cover you. If you wish the same coverage for your dependents, you can purchase additional coverage using a VISA or Mastercard credit card or a VISA Debit card.

Family Add-On Eligibility

There are 3 circumstances in which students enrolled in the Student Health and Dental Plan may add dependents to their plan: (1) when they are starting the fall term, (2) when they are new students, or (3) when they have a lifestyle change.

Family Add-On Eligibility

All eligible domestic and international students studying for more than 12 months at the Concordia University of Edmonton are automatically enrolled in the Student Health and Dental plans. Students get one opportunity per academic year to add dependents to their plans and must meet the following criteria in order to have their application approved:

1 Fall Academic Enrollment

Assessed the CSA Health and Dental Plan Fees on their student account; and
Must submit their family add-on application before the applicable fall deadline; and
Must pay the family add-on fees by the assigned deadline.

Eligible students who miss the fall deadline would be able to add dependents the following fall term if they are fall-enrolled students. Students will not be able to add dependents in the winter term.

2 Winter Academic Enrollment

New eligible winter students; and
Assessed the CSA Health and Dental Plan Fees on their student account; and
Must submit their family add-on application before the applicable winter deadline; and
Must pay the family add-on fees by the assigned deadline.

New eligible winter students who miss the winter deadline would be able to add dependents the following fall term if they are fall-enrolled students.

3 Spring-Summer Academic Enrollment

New eligible spring-summer students; and
Assessed the CSA Health and Dental Plan Fees on their student account; and
Must submit their family add-on application before the applicable spring-summer deadline; and
Must pay the family add-on fees by the assigned deadline.

New eligible spring-summer students who miss the spring-summer deadline would be able to add dependents the following fall term if they are fall-enrolled students.

4 Lifestyle Change

Assessed the CSA Health and Dental Plan Fees on their student account; and
had a lifestyle change such as getting married, meeting the co-habitation requirement for common law status, or birth/adoption of a child; and
Must submit their family add-on application within 30 days of the lifestyle change; and
Must pay the family add-on fees by the assigned deadline.

You must provide documentation such as a marriage certificate, birth certificate, or adoption documents by emailing concordiaplan@mystudentplan.ca. You have 10 business days to email the proper documentation or your application will be denied.

Eligible students who miss the 30 days deadline would be able to add dependents the following fall term if they are fall-enrolled students.

How to Add Family

To add dependents, you must be enrolled in the Student Benefits Plan, meet the Family Add-On eligibility criteria, and complete the online form before the applicable term deadline.

Steps to Add Dependents

Family Add-On Fees:

These are the fees to purchase family coverage, you must pay using a VISA or Mastercard credit card or a VISA Debit card before the applicable payment deadline.

Fall Fees

One dependent		Two or more dependents
Health	$155.00	Health	$155.00
Dental	$155.00	Dental	$310.00
Health and Dental	$310.00	Health and Dental	$465.00

Winter Fees

One dependent		Two or more dependents
Health	$105.00	Health	$105.00
Dental	$105.00	Dental	$210.00
Health and Dental	$210.00	Health and Dental	$315.00

Spring-Summer Fees

One dependent		Two or more dependents
Health	$80.00	Health	$80.00
Dental	$80.00	Dental	$160.00
Health and Dental	$160.00	Health and Dental	$240.00

These are the current family Add-on fees. However, the fees are subject to change without notice.
The Family Add-on fees are non-refundable and are not automatically renewed.
The Family add-on fees cover your dependents until August 31^st. If you wish to keep your family covered, you must submit a new application before the applicable fall deadline.
The family Add-On fees are not assessed as part of your term fees. If your application is approved, the Benefits Plan Office emails you a link, the payment deadline, and instructions to pay online using a VISA or Mastercard credit card or a VISA Debit card.

Things to consider:

You can only add as a dependent to your Student Benefits Plan your spouse or common-law partner and your children. Parents, grandparents, and siblings do not qualify as dependents.
Your dependents would be covered under your Student Benefits Plan, which means they would be entitled to the benefits you have through your plan.
Each dependent added uses the same Benefits Card that the student has. The Benefits Card must have the student's information (Full name and student ID).
Family Add-On fees are not automatically renewed every fall term. If students wish to keep the dependents covered, they must re-apply every fall.
NO EXCEPTIONS will be made if the application or payment is missed. It is the student's responsibility to check their emails regarding the status of the application or deadlines.

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

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

The family add-on form is accessible only to eligible students with lifestyle changes.

The spring-summer application period was from April 1^st, 2025 to May 20^th, 2025.

NO EXCEPTIONS are made if the deadline is missed. The student must pay the plan's mandatory fees, should they miss the applicable opt-out deadline.

Fall 2025: Online applications will open on August 1^st, 2025, and the deadline is September 20^th, 2025. This deadline applies to all eligible students.

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

Student ID Number

Email Address

Confirm Email Address

First Name

Last Name

Sex

F

M

U

Date of Birth

Date Month Field Date Day Field Date Year Field

Phone Number

Phone Area Number Phone Local Number Phone Digits

Program Name

Program Start Date

Date Month Field Date Day Field Date Year Field

Family Add-On applications are now closed

Family Add-On Applications

Fall Application Period

Family Add-On Eligibility

How to Add Family

Family Add-On Fees:

Fall Fees

Winter Fees

Spring-Summer Fees

The family add-on form is accessible only to eligible students with lifestyle changes.

Eligibility Confirmation

Have you been assessed the CSA Health and Dental Plan Fees on your student account?

Are you a new winter student who has been assessed the CSA Health and Dental Plan Fees on your student account?

Are you a new spring-summer student who has been assessed the CSA Health and Dental Plan Fees on your student account?

Are you a student enrolled in the CSA Health and/or Dental Plans and have a lifestyle change such as getting married, common-law status, or birth/adopting a child?

Are your family members eligible to be added to your CSA Health and/or Dental Plans?

Health and Dental Family Add-On Form

Student Information

Benefits Plan Office

General Inquiries Line

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