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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.

Calendar

The spring deadline to submit applications is closed.

The following online forms are not available at this time:

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

The online forms for the Summer 2023 term will be available on June 05th, 2023. The Deadline to submit applications for new or returning starting summer students is July 05th, 2023.

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

Submitting Online Forms

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

The summerspring deadline to submit online forms is July 5th, 2023was May 12th, 2023.

Opt-Out Application

Withdraw from the student plan 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 by completing the online form by the applicable term deadline.

Family Add-On Application

Extend your student plan to your dependents and have them covered with the same Health and Dental benefits by completing the online form by the applicable term deadline. Additional charges must be paid using a credit card.

Re-enroll Application

Re-enroll in the student Plan if you previously opted out or have lost your comparable insurance coverage by completing the online form by the applicable term deadline.