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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 re-enrolled? Eligible Students may submit their online forms.

The winter deadline to submit application is closed.

Calendar

Winter Deadline to submit applications was January 27th, 2023

The following online forms are not available at this time:

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

The online forms for Spring-Summer 2023 term will be available in April. The Deadline to submit applications for new spring-summer start students is May 25th, 2023.

If you were eligible for the plan for the first time in fall or 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.

Family Add-On Application

Extend your plan to your spouse or partner and children and provide the same protection you have. Additional charges must be paid using a credit card.

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.
Deadline

Winter Deadline to submit applications