URSU - Opt In Form

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 Re-enroll or Opt-In

All new eligible Fall domestic and international students are automatically enrolled in the Health and Dental plan so only submit a re-enrollment form if you have previously opted out of the plan or meet the special eligibility criteria for students not automatically eligible.

New winter term eligible students are not automatically enrolled and must apply to enroll before any applicable deadline.

Eligibility Criteria

There are 2 Circumstances for re-enrolling and 1 Circumstance for opting in to the Student Health and Dental Plan:

1 Upon Policy Anniversary

All eligible students who previously opted out of the health and dental plans may submit applications if they wish to re-enroll in the Health and Dental Plans in the following Fall term.

The policy Anniversary for all eligible students is September 1^st, please only complete this re-enroll form in the Fall term before the applicable fall deadline.

The fall deadline to apply will be posted soon.

2 Loss of Comparable Coverage

Students who have lost their comparable insurance coverage and are still eligible for the Student Plan may re-enroll in the plan. You must provide the proper documentation by emailing uofregina@mystudentplan.ca and completing the online form.

The deadline to apply is within 30 days of losing that coverage

3 Fall students not-eligible automatically for the Plan

Students may apply to opt-in to the Student Plan if they are in one of the following situations:

Students undergrad taking fewer than 9 Fall semester credit hours
Graduate student taking fewer than 6 Fall semester credit hours
Co-op Students
Students enrolled in the ATP/ ARP programs

The fall deadline to apply will be posted soon.

4 New Winter Start Students Only

New winter start students are not automatically enrolled in the plans and may apply to opt-in to the Student Plan if they are in one of the following situations:

Students starting their program or school in January
Undergraduate Students taking more or fewer than 9 winter semester credit hours
Graduate Students taking more or fewer than 6 winter semester credit hours
Co-op Students
Students enrolled in the ATP/ ARP programs

The winter deadline to apply is January 30^th, 2024.

Opt-In/Re-enroll Fees:

Fall Term		Winter Term, New Students Only
Health	$98.30	Health	$65.32
Dental	$120.20	Dental	$80.13
Health & Dental	$218.50	Health & Dental	$145.45

Important notes:

The effective date of your coverage is the 1^st day of the term when your program begins.
There is a 45 to 60-day validation period from the start of your 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.
NO EXCEPTIONS will be made if the deadline is missed.
Once you complete the opt-in or re-enrollment form, you will receive an automated email confirmation. Please keep this email for your records as it is your only proof of submitting a request.
After we confirm your eligibility, you will receive another email with the fees, a link to pay with your credit card, and the deadline to pay them.

Steps to submitting your opt-in or re-enroll application:

1Student Information

Complete this section below providing true and correct information. Click NEXT.

2Enrolment Circumstances

Scroll down and check Health Plan/Dental Plan/Qualify. You can choose Health or Dental or both plans. Select your status and Click NEXT.

3Read 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.

4Confirmation 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.

5Application status

You will receive an email with the status of your application.

6Pay the fees

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: uofregina@mystudentplan.ca

Health and Dental Re-enroll or Opt-In Form

Please complete all information on the re-enroll/Opt-In form and we will process your application as soon as we can.

Student Information

Student ID Number

Email Address

Confirm Email Address

First Name

Last Name

Sex

Date of Birth

Date Month Field Date Day Field Date Year Field

Phone Number

Phone Area Number Phone Local Number Phone Digits

Program Name

Program Start Date

Date Month Field Date Day Field Date Year Field

Winter Deadline
Submit your online Family Add-On or Opt-In applications by January 30^th, 2024

Plan Card Generator
Generate your Plan Card and use it where direct billing to Canada Life is available.

Prescription Search Tool
Find out if your prescription drugs are covered by the student plan.

Plan Claims
Learn more about submitting online or manual claims to Canada Life to get your refund.

URSU Benefits Plan Office

Email: uofregina@mystudentplan.ca
Phone: 306-586-8811
Address: Rm 221, Riddell Centre
3737 Wascana Parkway
Regina, SK. S4S 0A2

General Inquiries Line

Monday to Friday from 7:00am to 6:00pm CST

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

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