Forms

Attention Fall 201​8 intake students:

If you missed the September 28th opt-out deadline, you CANNOT opt-out in January 2019.

  

Only submit the form if you are a new ​Fall intake student. All submissions will be audited.

Already have coverage?

Coordinating multiple plans: If you are an eligible student and have comparable coverage you may wish to coordinate your plans. Benefits under the two plans can be coordinated to increase your coverage up to 100% of the actual expense(s) incurred. For example, following payment under this plan you can submit outstanding balances to the other plan for consideration. Find out more about coordination of benefits.

Opting Out of coverage: If you are an eligible student and have comparable health and/or dental coverage you may apply to opt-out of the plan(s). Each student is given one opportunity to opt-out of the health and/or dental plan(s) each year. All opt-out forms must be completed online or through the NAITSA Service Hub and must be received by the applicable deadline. You will not be able to opt-out of coverage at any other point during the school year. NO EXCEPTIONS will be made if the deadline is missed. It is the student's responsibility to pay the plan fees, should they miss the applicable opt-out deadline.

Approval of your opt-out will result in the plan fee being credited. Once your opt-out has been accepted, it will remain in force as long as you remain an eligible student.

If you are unsure about whether or not you are eligible for the Student Health & Dental plan, please contact the NAITSA Service Hub prior to any applicable deadlines.

Please read and agree to the Terms & Conditions prior to submitting your online opt-out.

Opt In

Student Health & Dental Plan coverage is provided to eligible students automatically, except in certain circumstances where a student's enrolment status excludes them from automatic inclusion by the institution or due to a previous waiver on file. To enroll in the Student Health and/or Dental plan(s), complete the sections below and submit this form. You will then be contacted by the NAITSA Service Hub, via an email notification, of any required supporting documents and/or fees. All supporting document(s) and/or fees must be received by the applicable deadline in order for the enrolment process to be completed.

Please read and agree to the Terms & Conditions prior to submitting your online enrolment form.

Family Add On

Coverage provided through the Student Health & Dental plan can be extended to a spouse and/or dependent(s). To add eligible dependent(s) complete the sections below and submit this form. You will then be contacted by the NAITSA Service Hub, via an email notification, of any required supporting documents and fees. All supporting document(s) and fees must be received by the applicable deadline in order for the family add-on process to be completed.

Please read and agree to the Terms & Conditions prior to submitting your online Family Add-On form.