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

Calendar

The Spring-Summer 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 term will be available in August. The Deadline to submit applications for eligible students is September 27th, 2023.

If you were eligible for the plan for the first time in the winter or spring-summer term and missed the deadline, your next opportunity to submit applications would be the winter 2024 or the spring-summer 2024 term respectively.

Submitting Online Forms

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

The Spring-Summer deadline to submit online forms iswas May 25th, 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 term 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 term deadline. Additional charges must be paid using a credit card.

Re-enroll Application

Re-enroll in the student Plan if you previously opted out and have lost your comparable insurance coverage by completing the online form by the applicable term deadline.