Student Health and Wellness

Group Number: 330757
Certificate Number: Student ID
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Call Centre: 1-866-586-1010
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Health and Dental Plan Coverage for prescription drugs, dental care, health services, and more, helping with costs your provincial health plan doesn’t cover.

Family Add-On Applications

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

Winter Application Period

December 1^st, 2025 to January 15^th, 2026 at 4:00 pm

Make sure to submit your form by January 15^th as the online form will be accessible only to eligible students with 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 VISA or Mastercard credit card or a VISA Debit card.

Family 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 new students, (2) when they are returning students on the anniversary of enrolling in the Student Benefits Plan, or (3) when they have a lifestyle change.

Family Add-On Eligibility

How to Add Family

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 VISA or Mastercard credit card or a VISA Debit card online or by cash, debit, or VISA or Mastercard credit card or a VISA Debit card at the Student Benefit Plan Office before the applicable payment deadline.

One dependent		Two or more dependents
Health	$315.00	Health	$315.00
Dental	$225.00	Dental	$315.00
Health and Dental	$540.00	Health and Dental	$630.00

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 for 12 months. If you wish to keep your family covered, you must submit a new application before the applicable term 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 VISA or Mastercard credit card or a VISA Debit card.

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 Benefit Cards as the student. The Benefits Card must have the student's information (Full name and student ID).
Family Add-On fees are not automatically renewed every year. If students wish to keep the dependents covered, they must re-apply every 12 months (On the anniversary of adding dependents).
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.

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

Questions? Please contact your Benefit Plan Office: sahealthplan@rdpolytech.ca

The family add-on form is accessible only to eligible students with lifestyle changes.

The winter application period was from December 1^st, 2025 to January 15^th, 2026.

NO EXCEPTIONS are made if the deadline is missed.

Spring 2026: Online applications will open on April 1^st, and the deadline is May 15^th, 2026. This deadline applies only to new spring-eligible students or returning students who started their studies in the spring term. Applications from other students will be rejected.

Health and Dental Family Add-On Form

Please complete all information on the family add-on form 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

Winter Deadline
Submit your online Family Add-On, Opt-Out, or Opt-In applications by January 15^th, 2026 at 4:00PM. This deadline applies only to new winter-eligible students.

Benefit Cards
Get your Benefits Card on your Benefits App and use it where direct billing is available.

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

Plan Claims
Learn more about submitting online or manual claims to get your refund.

Family Add-On applications are now closed

Family Add-On Applications

Winter Application Period

Family Add-On Eligibility

How to Add Family

Family Add-On Fees:

The family add-on form is accessible only to eligible students with lifestyle changes.

Health and Dental Family Add-On Form

Student Information

Benefits Plan Office

Health and Dental Inquiries

Claim Inquiries

International Medical Plan Inquiries