Student / Dependent Enrollment

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Welcome to the Student / Dependent Enrollment Center! We are here to help make enrolling as easy and as painless as possible.

We suggest you review the brochure for your rates, effective dates and optional coverages before starting the enrollment process. The plan’s benefits can be found in the brochure within the Schedule of Benefits section with the exclusions towards the back.

View your brochure

 

2013 - 2014 School Year Coming Soon!

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2012 - 2013 School Year

 

HARD WAIVER STUDENT ENROLLMENT INSTRUCTIONS
If you are a……
full-time undergraduate student taking 12 or more credit hours, a graduate student or matriculated students taking 9 or more credit hours you are required to enroll in this insurance plan unless proof of comparable coverage is furnished. 
 
enroll now IN COVERAGE ON-LINE (Hard Waiver students only)
 
  •  Annual Enrollment Deadline: 9/28/12
  • Spring/Summer Enrollment Deadline: 2/22/13
  • Summer Enrollment Deadline: If you are a new incoming student for the Summer Session, enrollment is voluntary.
 

PLEASE NOTE: For Hard Waiver Students, the Optional Major Medical Coverage cannot be purchased through the Enroll/Waive site. For Hard Waiver Students to enroll in the Optional Major Medical coverage, you must fill out an enrollment form and mail it in with your payment. The enrollment form with payment must be received in our office within two weeks after enrolling in the basic coverage. If received after the two week grace period, you will not be eligible to enroll in the Optional Major Medical and your enrollment form and payment will be returned to you. Please download the Enrollment Form for Major Medical below.
If you have missed the hard waiver enrollment deadline, but have not previously waived out of the insurance, you will be automatically enrolled in the insurance by your school. 
 If you have previously waived out of the insurance and would like to enroll, or if your non-school sponsored coverage is being terminated and you are now looking to enroll in the Student Injury & Sickness plan,

 

 

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Major Medical

 

Major Medical is an additional optional benefit you may choose to purchase, in addition to the basic policy.
 
Hard-Waiver Students, Voluntary Students, and Dependents are eligible to purchase the Major Medical benefit for an additional premium.
Hard-Waiver Students have 2 weeks from the date of their enrollment in the basic program to enroll themselves in the Major Medical benefit.
Voluntary Students and all Dependents must enroll in Major Medical at the time of their initial enrollment.
For more detailed information on the Major Medical benefit please refer to your Brochure.
Please see enrollment instructions below.
 

 

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Voluntary Students

 

If you are a….
Montclair State University part-time student taking 3 or more credit hours, you are eligible to enroll in this insurance Plan on a voluntary basis. To Enroll, please see the Major Medical, Voluntary Students & Dependent Enrollment Instructions below.

PLEASE NOTE: For Voluntary Students, the Optional Major Medical Coverage must be purchased simultaneously and in conjunction with the purchase of Basic coverage at the time of initial enrollment in the plan for you and your dependents and may not be added later.

 

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Dependents

 

Eligible dependents, including Domestic partners, of enrolled students may participate in the plan on a voluntary basis. To enroll your Dependents, see the Enrollment Instructions below.

 

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Enrollment Instructions for Part-Time Students, Dependents, and Major Medical Coverage

 


Voluntary Students: Have your credit card ready! If you are already enrolled and only need to enroll your dependents, you will not be able to use this method. You must enroll your dependents with an enrollment form or through MY ACCOUNT. Please see below.



Full-Time and Part-Time Students: If you are already enrolled and only need to enroll your dependents, you will need to create a “MyAccount”. Once you are logged in, you may enroll your dependents by clicking on the “Dependent Enrollment” button on the MyAccount page. This will allow you to enroll your dependents without being charged a second time for the student premium.(If you are a Full-Time Student already enrolled and ONLY need to enroll in the Optional Major Medical, you cannot use this method. You must enroll with an enrollment form.)

                                                                                OR
  •  ENROLL BY MAIL
 
Download an enrollment form and submit by mail using a check or money order. The mailing address is listed on the back of the Enrollment Forms.

(The effective date of your coverage will be the date you enrolled on-line or the date we received the enrollment form with full payment in our office.)
 

 

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Enrollment Forms

 

FULL-TIME STUDENT MAJOR MEDICAL & DEPENDENTS 
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PART-TIME STUDENTS MAJOR MEDICAL & DEPENDENTS

 

FrontierMEDEX Travel Assistance Program

Travel Assistance is included in the Montclair University Student Injury and Sickness Plan.  If you did not enroll in your school's plan, you may still enroll only for the Travel Assistance Program. 

 

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If you have any questions about the enrollment process, please call 800-505-4160 or 

We are always happy to help in anyway.