KSA - Family Add 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 Family Add-On Application

Deadline to Add Family to your Student Plan

30 days from the official start date of your program

After the deadline, the online form is only available for students who have lifestyle changes.

The fees on the student account cover the student only. You can extend your coverage to your dependents to have the exact same coverage. Additional charges must be paid using a credit card.

Family Add-On Eligibility

There are 2 circumstances in which students enrolled in the Student Health and Dental Plan may add dependents: (1) When they are new students or returning students on the anniversary of starting an eligible full-time program, and (2) when they have a lifestyle change.

Eligibility to Add Dependents

How to Add Family

To apply to Add Dependents, you must be enrolled in the Student Plan, meet the family add-on eligibility criteria, and complete the online form before the applicable deadline.

Steps to Add Dependents

Family Add-On Fees:

These are the fees to purchase family coverage, you must pay using a credit card (Visa® or MasterCard®) before the applicable payment deadline.

One dependent		Two or more dependents
Health	$120	Health	$120
Dental	$160	Dental	$240
Health and Dental	$280	Health and Dental	$360

These are the current family Add-on fees. However, the fees are subject to change without notice.
These fees are not included in your tuition, and you will pay them with a credit card on our website if your application is approved.
The Family add-on fees cover 12 months of coverage.
The Family Add-on are non-refundable.

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 plan card that the student has. The plan card must have the student's information (Full name and student ID).
Family Add-On fees are not automatically renewed every year. If students wish to keep the dependents covered, they must re-apply every 12 months (On the anniversary of adding dependents).
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: kwantlenplan@mystudentplan.ca

Eligibility Confirmation

Confirm your eligibility to add your family to the Student Benefits Plan by completing the following questions.

Are you a new student who has been assessed the Student Assn Ext. Dental Plan and Student Assn Ext. Health Plan fees on your student account?

Yes

No

Are you a returning student on the anniversary of your enrollment in the Student Benefits Plan who has been assessed the Student Assn Ext. Dental Plan and Student Assn Ext. Health Plan fees on your student account?

The anniversary refers to when you first became eligible for the Student Plan and were assessed the fees. For instance, if you were first eligible for the Student Plan in January, your anniversary would happen every January.

Yes

No

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

You may only apply within 30 days of the lifestyle change. After the deadline, your application will be denied.

Yes

No

Are your dependents eligible to be added to your Student Plan?

You can only extend your plan to your spouse or common-law partner and your children. Please check the eligible dependents.

Yes

No

You meet the eligibility criteria to add dependents to your 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.

The Family Add-on fees are non-refundable and are not automatically renewed. Students must apply and purchase family coverage every year if they wish to keep their dependents covered.

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 Family add-on form, you will receive an automated email confirmation. Please keep this email for your records as it is your only proof of submitting a family add-on request.

It appears you do not meet the criteria to add dependents to your plan at this time.

If you have not been assessed the Student Assn Ext. Dental Plan and Student Assn Ext. Health Plan fees on your student account, you are either not eligible for the Student Benefits Plan or currently have an active opt-out on file.

Only new students or returning students enrolled on the anniversary of starting their program, who have been assessed the Student Assn Ext. Dental Plan and Student Assn Ext. Health Plan fees and are enrolled in an eligible program having one or more credits at Kwantlen Polytechnic University may apply to add dependents.

The next opportunity to submit your online application would be on the anniversary of the date of starting your program.

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 kwantlenplan@mystudentplan.ca or by phone at 604-599-2431.

It appears you do not meet the criteria to add dependents to your plan at this time.

Only students enrolled in the Student Benefits Plan and have a lifestyle change such as getting married, common-law status or birth/adopting a child may apply to add their dependents at any time of the academic year within 30 days from the lifestyle change date.

If you have not been assessed the Student Assn Ext. Dental Plan and Student Assn Ext. Health Plan fees on your student account, you are either not eligible for the Student Benefits Plan or currently have an active opt-out on file.

Only new students or returning students enrolled on the anniversary of starting their program, who have been assessed the Student Assn Ext. Dental Plan and Student Assn Ext. Health Plan fees and are enrolled in an eligible program having one or more credits at Kwantlen Polytechnic University may apply to add dependents.

The next opportunity to submit your online application would be on the anniversary of the date of starting your program.

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 kwantlenplan@mystudentplan.ca or by phone at 604-599-2431.

It appears you do not meet the criteria to add dependents to your plan at this time.

Only eligible dependents can be added to your Student Plan. Students can add the following dependents to their plan:

Spouse: By marriage or under any other formal union recognized by law, or your common-law spouse of either sex who has cohabitated with the student minimum for one year.
Children: Your natural children, stepchildren, legally adopted children, and children for whom you/and or your spouse have been appointed as guardian(s) for all purposes under an Order of the Court.
1. Unmarried
2. Under 21 years of age and not employed full-time
3. Under 25 years of age, if they are attending a college or university full-time, or
4. Physically or mentally incapable of self-support and became incapable to that extent while entirely dependent on the student for maintenance and support and while eligible under 1) or 3) above

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 kwantlenplan@mystudentplan.ca or by phone at 604-599-2431.