GCSA - Enrollment Form

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.

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.

Health and Dental Enrollment Application

Deadline to enroll in the Student Benefits Plan

Spring-Summer term - May 30^th, 2024

After the deadline, the online form is only available for students who have lost their comparable coverage.

Enrollment Eligibility

There are 3 circumstances in which students may enroll in the Student Benefits Plan: (1) when they opted out and are starting the fall term or (2) when they opted out and are within 30 days of losing their alternate coverage, or when they are considered full-time equivalent (60% course load).

Eligibility to Enroll

How to Enroll

To apply to enroll, you must be opted out of the Student Plan, meet the enrollment eligibility criteria, are eligible for the Student Plan, and complete the online form before the applicable term deadline.

Steps to Enroll

Student Health and Dental Fees:

These are the fees to re-enroll in the Student Benefits Plan. If an application is approved, the student receives an email with instructions to pay the assessed fees.

Fall Fees

Health	$89.00
Dental	$76.00
Health and Dental	$165.00

Winter Fees

Health	$59.33
Dental	$76.00
Health and Dental	$135.33

Spring-Summer Fees

Health	$29.67
Dental	$76.00
Health and Dental	$105.67

Things to consider:

All eligible students are automatically enrolled in the Student Health and Dental Plan and do not need to submit an opt-in form. You will see the Health Insurance Fee and the Dental Insurance Fee on your student account to confirm you are enrolled.
Students choosing to enroll in the Health, the dental or both plans.
Approval of the Student Benefits Plan enrollmentment application will result in the Health Insurance Fee and/or the Dental Insurance Fee being assessed on your student account.
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: georgianplan@mystudentplan.ca

The winter enroll deadline is closed.

The winter deadline to apply was January 30^th, 2024. The online Enroll Form is not available at this time. The online form was open from December 1^st, 2023, until January 30^th, 2024.

NO EXCEPTIONS will be made if the deadline is missed.

If you were eligible for the plan for the first time in the fall or winter term and missed the deadline, your next opportunity to apply should be the fall 2024 term.

The online form will be open for all eligible spring-summer students on April 1^st, 2024, and the deadline to apply is May 30^th, 2024.

The online form is only available for students who have lost their comparable coverage.

Eligibility Confirmation

Confirm your eligibility to enroll in the Student Benefits Plan by completing the following questions.

Are you a new student taking a 60% or more course load who has been considered a full-time student by a learning accommodation services advisor from the Georgian College?

Yes

No

Have you ever Opted Out of the Student Health and Dental Plan?

Yes

No

Have you lost your comparable health and dental Coverage?

Yes

No

You meet the eligibility criteria to re-enroll in the plan at this time.

Complete the online form below to submit your application. Completing the questionnaire does not mean that your application is approved, the Student Benefits Plan Office will confirm your eligibility and process your application.

There is a 45-day validation period from the start of the term. During this time, you would have to pay out of pocket for all eligible Health and Dental expenses and keep the receipts. After the enrollment process is complete, you will be able to submit online claims for reimbursement, and your Plan Card will be automatically activated.

Once you submit the re-enroll form, you will receive an automated email confirmation. Please keep this email for your records as it is your only proof of submitting a re-enroll request.

It appears you do not meet the criteria to re-enroll in the plan at this time.

Only students who previously opted out of the Health and Dental Plan may apply to re-enroll.

All eligible domestic and international students enrolled in an eligible program as having full-time status at the Georgian College are automatically enrolled in the Student Benefits Plan. There is no opt-in option for students attending non-eligible programs.

If you have any questions, please initiate a chat by clicking on the right-bottom corner icon or contact the Benefits Plan Office by email at georgianplan@mystudentplan.ca or by phone at 705-722-5181.

It appears you do not meet the criteria to re-enroll in the plan at this time.

Only Students who previously opted out of the Student Plan and have lost their comparable coverage may re-enroll at any time of year within 30 days of the loss of coverage.

The next opportunity to submit your online opt-out application would be in the upcoming fall term.

If you have any questions, please initiate a chat by clicking on the right-bottom corner icon or contact the Benefits Plan Office by email at georgianplan@mystudentplan.ca or by phone at 705-722-5181.

Health and Dental Re-Enroll or Accessibility Opt-In Form

Please complete all information on the re-enroll 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

Campus

Program Name

Program Start Date

Date Month Field Date Day Field Date Year Field

Spring-Summer Deadline
Submit your online Family Add-On, Opt-Out, or Opt-In applications by May 30^th, 2024

Plan Card Generator
Generate your Plan Card and use it where direct billing to Canada Life is available.

Prescription Search Tool
Find out if your prescription drugs are covered by the student plan.

Plan Claims
Learn more about submitting online or manual claims to Canada Life to get your refund.

Barrie & ILAC@Georgian Students

Email: georgianplan@mystudentplan.ca
Phone: 705-722-5181
Address: A Building, A159

Orillia Students

Email: Gail.Hudson@GeorgianCollege.ca
Phone: 705-329-3114
Address: GCSA Office - Room # A111

Owen Sound Students

Email: georgianplan@mystudentplan.ca
Phone: 519-372-2617
Address: GCSA Office - Room # D102

General Inquiries Line

Monday to Friday from 5:00am to 4:00pm PST

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

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