Family Add-On Applications

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

Fall Application Period

August 1st, 2024 to September 30th, 2024

Make sure to submit your form by September 30th 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.

optoutFamily Add-On Eligibility

There are 3 circumstances in which students enrolled in the Student Health and Dental Plan may add dependents to their plan: (1) when they are starting the fall term, (2) when they are new students, or (3) when they have a lifestyle change.

Family Add-On Eligibility

How to Add Familyhow-to-re-enroll

To add dependents, you must be enrolled in the Student Benefits Plan, meet the Family Add-On eligibility criteria, and complete the online form before the applicable term 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 FAMILY MEMBER TWO OR MORE FAMILY MEMBERS
Health $180 Health $180
Dental $180 Dental $360
Health and Dental $360 Health and Dental $540
  • These are the current family Add-on fees. However, the fees are subject to change without notice.
  • The Family Add-on fees are non-refundable and are not automatically renewed.
  • The Family add-on fees cover your dependents until August 31st. If you wish to keep your family covered, you must submit a new application before the applicable fall deadline.
  • The family Add-On fees are not assessed as part of your term fees. If your application is approved, the Benefits Plan Office emails you a link, the payment deadline, and instructions to pay online using a credit card.
things-to-considerThings to consider
  1. 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.
  2. Your dependents would be covered under your Student Benefits Plan, which means they would be entitled to the benefits you have through your plan.
  3. 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).
  4. 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.
  5. 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

Sex
Date of Birth
Phone Number
Program Start Date

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

Plan Leaflet

Plan Leaflet
Get a summary of eligible expenses and maximum reimbursements of your Student Benefits Plan.

Prescription Search Tool

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