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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 Opt-Out Application

Winter deadline to submit applications
January 26th, 2024

Eligible students who have comparable Health and Dental coverage, and meet the following eligibility criteria may apply to opt out of the benefits before the applicable term deadline.

ONLY new eligible winter students or eligible students who started a program in the winter term may apply. If you started in the spring, summer, or fall term, you could not apply in the winter term, your next opportunity would be on the anniversary of starting your program.

Eligibility Criteria

There are 2 circumstances for opting out of the Student Health and Dental Plan:

1New Students

Eligible new students who have comparable Health and Dental coverage from their parents, spouse, government, job, or band may apply to opt out of the plan by the applicable term deadline.

2Returning Students

Eligible returning students enrolled in their anniversary of starting an eligible program who have comparable Health and Dental coverage from their parents, spouse, government, job, or band may apply to opt-out of the plan by the applicable term deadline.

Deadline to Submit Applications

Eligible students must submit their applications before the applicable term deadline. NO EXCEPTIONS will be made if the deadline is missed. Before submitting an application make sure that you meet the eligibility criteria above.

Winter 2023
January 27th, 2023

Spring 2023
May 12th, 2023

Summer 2023
July 5th, 2023

Fall 2023
September 22nd, 2023

Things to consider when thinking of opting out:

  • A parents' insurance plan will stop covering you if you are a part-time student over the age of 21 or a full-time student over the age of 25.
  • You can coordinate 2 benefit plans and increase your coverage up to 100%! Find out more Coordination of Benefits
  • What is in the best interest of my overall health and well-being?
  • Does my existing coverage meet all my needs?
  • The only time you can get back on this student plan is at the anniversary of starting your program (every year) OR within 30 days of losing your comparable coverage.

Proof of Comparable Coverage

You are required to provide proof of your comparable extended health and dental coverage by attaching documentation displaying the policy information when you are completing the online form.

Confirmation of coverage must show the name of the insurance company providing the coverage and the policy number. Acceptable forms of confirmation of coverage are:

  • Copy of a Plan Card (front and back images).
  • Confirmation letter from the employer or insurance company with a current date.
  • Recent health care claim statement with the current date (within 3 months of application submission).
  • Webpage printout with a visible current date.
Important notes:
  • Alberta Health Care Insurance Plan (AHCIP) or The Student Plan is not acceptable as comparable insurance coverage.
  • The comparable coverage accepted could be from parents, spouse, work, government, or band.
  • Approval of an opt-out application will result in the plan fee being refunded to the bank account indicated on your online opt-out form. Once an opt-out application has been accepted, it will remain in force as long as you remain an eligible student.
  • Approval of the Students opt-out will result in the plan fee being refunded according to the school's policy. The Opt-Out result is a one-time process. This means students do not need to apply every term or year.
  • NO EXCEPTIONS will be made if the deadline is missed. It is the student's responsibility to pay the plan's mandatory fees, should they miss the applicable opt-out deadline.
  • Once you complete the opt-out form, you will receive an automated email confirmation. Please keep this email for your records as it is your only proof of submitting an opt-out request.

Steps to Submitting a Health and Dental Opt-Out Application:

1 Student Information
Complete this section below providing true and correct information. Click NEXT.
2 Health Plan Opt-Out
Scroll down and check yes/no if you wish to opt-out of the health portion of the student plan. Provide the alternate insurance company name and policy number. Click NEXT.
3 Dental Plan Opt-Out
Scroll and check yes/no if you wish to opt out of the dental portion of the student plan. Provide the alternate insurance company name and policy number. Click NEXT.
4 Proof of Coverage
You are required to attach documentation of your confirmation of health and dental comparable coverage. Click NEXT.
5 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.
6 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.

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

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

Health and Dental Opt-Out Form



Student Information

Date of Birth
Phone Number
Program Start Date

SU Benefits Plan Office

Email: uofcalgaryplan@mystudentplan.ca
Phone: 403-220-3906
Address: 2500 University Drive NW
MSC 352
Calgary, Alberta. T2N 1N4

General Inquiries Line

Monday to Friday from 6:00am to 5:00pm MST

Phone: 1-877-746-5566 Ext. 7249

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