Student Health and Wellness

Family Add-On Applications

Submit your health, dental, or health and dental family add-on application before the deadline.

Fall Application Period

August 1^st, 2024 to September 30^th, 2024

Make sure to submit your form by September 30^th as the online form will be accessible only to eligible students who have lifestyle changes.

Your student account fees only cover you. If you wish the same coverage for your dependents, you can purchase additional coverage using a credit card.

Fall Academic Enrollment

Assessed the Health Insurance Fee and Dental Insurance Fee on their student account ; and
Must submit their family add-on application before the applicable fall deadline; and
Must pay the Family add on fees by the assigned deadline.

Eligible students who miss the fall deadline would be able to add dependents the following fall term if they are fall-enrolled students. Students will not be able to add dependents in the winter term.

Winter Academic Enrollment

New eligible winter students or returning students who did not attend fall term; and
Assessed the health insurance fee and dental insurance fee on their student account; and
Must submit their family add-on application before the applicable winter deadline; and
Must pay the Family add on fees by the assigned deadline.

New eligible winter students who miss the winter deadline would be able to opt out the following fall term if they are fall-enrolled students.

Lifestyle Change

Assessed the Health Insurance Fee and Dental Insurance Fee on their student account; and
Had a lifestyle change such as getting married, meeting the co-habitation requirement for common law status, or birth/adoption of a child; and
Must submit their family add-on application within 30 days of the lifestyle change; and
Must pay the Family add on fees by the assigned deadline.

You must provide documentation such as a marriage certificate, birth certificate, or adoption documents by emailing macewanplan@mystudentplan.ca. You have 10 business days to email the proper documentation or your application will be denied.

Eligible students who miss the 30 days deadline would be able to add dependents the following fall term if they are fall-enrolled students.

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 fall term. If students wish to keep the dependents covered, they must re-apply every fall.
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.

Health and Dental Family Add On Form

To add your dependents to your Student Health and Dental Plan, provide us with the following information 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

Program Name

Program Start Date

Date Month Field Date Day Field Date Year Field

Add donotreply@gallivan.ca to your address book. Please do not reply to this email.

Questions? Please contact your Benefit Plan Office: macewanplan@mystudentplan.ca