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Online Forms

Are you covered by a comparable plan? Do you wish to cover your dependents? Or Have you opted out of the plan and wish to be re-enrolled? Eligible Students may submit their online forms.

The winter deadline to submit applications is closed.

Calendar

Winter Deadline to submit applications was January 20th, 2023

The following online forms are not available at this time:

  • Health & Dental Opt-Out
  • Health & Dental Family Add-on

The online forms for Fall 2023 term will be available in August. The deadline to submit applications for all eligible students is September 23rd, 2023.

If you were eligible for the plan for the first time in Winter term and missed the deadline, your application will be denied.

Submitting Online Applications

Before submitting your online forms, please review the eligibility criteria and read the Terms and Conditions.

Opt-Out Application

If you are covered by a comparable Health and Dental Plan from parents, spouse, work, government, or band and do not wish to Coordinate Benefits, you may submit an online Opt-Out application.
Opt-Out formOpt-Out Eligibility

Family Add-On Application

Extend your plan to your dependents and provide the same protection you have. Additional charges that must be paid using a credit card.
Family Add On FormFamily Add On Eligibility

Re-enroll Application

If you previously opted out of the plan and have lost your comparable coverage or a lifestyle change occurred, you may re-enroll into the Student Plan.
Re-enroll Form
Deadline

Winter Deadline to submit applications
Quick links Opt Out

Online Forms Deadline
Add Family, Opt-in or Opt-out
Submit your applications before: September 23, 2022

Quick links myBenefits Card

Generate the myBenefits Card
Access direct billing with pharmacies and dental offices. Generate it now!

Quick links Perscription search tool

Prescription Search Tool
Find out if your prescription drugs are covered

myWellness

myWellness
Click here to take your free mental health assessment.