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Student Health & Wellness!mystudentplan is a benefits plan for students and can provide coverage for prescription drugs, vision care, dental care, mental health counseling, and more. The plan is designed to supplement provincial health insurance and provide additional access to medical services.

 

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.

Health and Dental Family Add-On Application

Winter deadline to submit applications
January 19th, 2024

Eligible students who are enrolled in the Benefits Plan may apply by the applicable deadline to extend their coverage to their dependents.

Health and Dental insurance fees on the student account are for the student only. Students must apply and pay additional fees to have their family members added.

Eligibility Criteria

There are 2 circumstances for adding family members to the Student Health and Dental Plan:

1 Academic Enrollment

Eligible students who wish to extend their benefits to their dependents may apply according to the school enrollment:

  • Fall Enrollment: All eligible students may apply to add their dependents to the benefit plan before the fall deadline.
  • Winter Enrollment: Only new eligible students may apply to add their dependents by the winter deadline.
  • Spring-Summer Enrollment: Only new eligible students may apply to add their dependents by the winter deadline.

If you miss the term deadline, the next opportunity to add family members will be next fall.

2 Lifestyle Change

Students enrolled in the plan who have a lifestyle change such as getting married, meeting the twelve-month co-habitation requirement for common law status, or birth/adoption of a child who wish to extend their plan to their dependents may apply within 30 days of lifestyle change.

To apply, please email proof of Lifestyle Change to the Benefit Plan Office at ridgetownplan@mystudentplan.ca. If you are eligible to add family members, the office will send a link for the application.

Documentation includes a marriage certificate, birth certificate, or adoption documents.

If you miss the lifestyle change deadline, the next opportunity to add family members will be next fall.

Family Add-On Fees for the Fall Term:

ONE FAMILY MEMBER TWO OR MORE FAMILY MEMBERS
Health $165.00 Health $165.00
Dental $165.00 Dental $330.00
Health & Dental $330.00 Health & Dental $495.00
  • These are the current family Add-on fees. However, the fees are subject to change without notice.
  • These family fees are not included in your tuition. After the deadline, once your family Add-On is approved, you will be sent a payment link and must pay with a credit card by the applicable payment deadline.
  • The Family Add-on fees cover from September 1st to August 31st for applications approved in Fall. Family Add On requests & fees are not automatically renewed. If you wish to keep the coverage, you must apply again next fall 2024 term.
  • The fees for Family Add-on are non-refundable.
Important notes:
  • You can only extend your plan to your spouse or partner and your children. Parents, grandparents, and siblings are not eligible dependents to extend your plan. Please check the eligible dependents.
  • If you are an international student, please note this is not for emergency coverage. This is extended health and dental coverage for services not covered by an emergency plan. You will be required to provide proof of purchasing emergency coverage for any dependents included on the family add-on form.
  • The family members would be covered by the same plan the student has.
  • The benefit year coverage is the same for students and family members. For eligible students starting in the fall semester, coverage begins September 1st and ends August 31st. For eligible students starting in the winter semester. Coverage begins January 1st and ends August 31st. For eligible students starting in the summer semester. Coverage begins May 1st and ends August 31st.
  • Family Add On requests & fees are not automatically renewed. If students wish to keep the coverage, they must submit a new Family Add-On Application and must pay the additional fees every year by the applicable deadline. The form request deadline and the payment deadline are not the same. The payment deadline is set based on the day the request is approved.
  • There is a 60-day validation period from the start of the program. During this time, you would have to pay out of pocket for all eligible Health and Dental expenses and keep the receipts. After the enrollment process is complete, you will be able to submit online claims for reimbursement and your Plan Card will be automatically activated.
  • Each family member uses the same card that the student has. The card must have the student's information (Student's full name and student ID).
  • The fees for Family Add-on are non-refundable.
  • NO EXCEPTIONS will be made if the application or payment deadline is missed. The form request deadline and the payment deadline are not the same. The payment deadline is set based on the day the request is approved. It is the student's responsibility to check their emails.
  • Once you submit the Family add-on form, you will receive an automated email confirmation. Please keep this email for your records as it is your only proof of submitting a family add-on request.

Steps to Submitting a Family Add-On Application:

1 Student Information
Complete this section below providing true and correct information. Click NEXT.
2 Dependent Information
Scroll down and check Spouse/Child/Children according to the members you wish to add. Provide full name, initials, gender, and date of birth for each member. Click NEXT.
3 Read and Agree to the Terms and Conditions
Click on the checkbox to indicate that you agree to the Terms and Conditions agreement. Click SUBMIT to finish your application.
4 Confirmation Email
Check your email and verify if you have received the confirmation email.
If you do not receive this email, you must resubmit the form.
5 Application Status
You will receive an email with the status of your application.
6 Pay Fees Online
If your application is approved, you will receive a link to pay the applicable fees with your credit card and the deadline to pay them.

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

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

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

Sex
Date of Birth
Phone Number
Program Start Date