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Enrolling your Family

Family Add On

FALL UNDERGRADUATE STUDENTS' DEADLINE Thursday, September 23, 2022, 11:30 PM. EST

Each year, students are given one opportunity to purchase family coverage for their spouse and/or dependent(s) by completing an application form online and paying the family coverage fee. Family add-on forms must be received by the applicable deadline. Family coverage is then added during the enrolment processing period.

Family coverage must be re-purchased each year and is the student's responsibility to do so by the applicable deadline.

A student's family can only be covered while they are enrolled as a student on the plan.

For information about eligible family members please refer to the "Am I Covered" tab.

Coverage provided through the Student Health and 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 Student Benefits Plan Office, 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. IMPORTANT: These fees are in addition to the student health and dental fee. 

UNDERGRADUATE STUDENTS - Coverage period September 1, 2022 to August 31, 2023

Health Plan (one or more dependent) - $490.70
Dental Plan (one or more dependent) - $473.50
Health and Dental plan (one or more dependent) - $964.20

Family add-on coverage is not automatically renewed each year. In order for your family add-on to continue, you must purchase the coverage each benefit year before the applicable deadline. FAMILY ADD-ON FEES ARE NON-REFUNDABLE.  

Student Information

Date of Birth
Phone Number
Program Start Date

Service Members

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