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

Calendar

The winter deadline to submit applications is closed.

The following online forms are not available at this time:

  • Health & Dental Opt-Out
  • Health & Dental Family Add-on

The online forms for the fall 2023 semester will be available Monday, September 18th, 2023.

The Deadline for eligible students to submit Family Add-On or Re-enroll/Opt-In applications is Friday, September 29th, 2023, at 4:00 pm, and to submit Opt-Out applications is September 30th, 2023.

Submitting Online Forms

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

The winter deadline to submit online forms iswas January 31st, 2023.

Opt-Out Application

Withdraw from the student plan 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 by completing the online form by the applicable semester deadline.

Family Add-On Application

Extend your student plan to your dependents and have them covered with the same Health and Dental benefits by completing the online form by the applicable semester deadline. Additional charges must be paid using a credit card.

Re-enroll or Opt-In Application

Re-enroll in the student Plan if you previously opted out or have lost your comparable insurance coverage OR Opt-In to the Student plan if you are non-automatically-eligible students by completing the online form by the applicable semester deadline.