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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.

The Spring-Summer deadline to submit application is closed.

Calendar

Spring-Summer Deadline to submit applications was May 30th, 2023

The following online forms are not available at this time:

  • Health & Dental Opt-Out
  • Direct Deposit Update
  • Health & Dental Family Add-on

The online forms for fall 2023 term will be available in August. The Deadline to submit applications for all eligible fall students is September 30th, 2023.

If you were eligible for the plan for the first time in winter or spring-summer term and missed the deadline, your next opportunity would be in the fall term.

Submitting Online Forms

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

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 term deadline.

Direct Deposit

Update your direct deposit information if you have previously opted out of the student benefits plan and have changed your banking information to make sure that you get the opt-out refund.

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 term 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 and wish to have extended health and dental coverage by completing the online form by the applicable term deadline.

Deadline

Spring-Summer Deadline to Submit Online Forms