Student / Dependent Enrollment
We suggest you review your brochure and rates before starting the enrollment process. The plan’s benefits can be found in the brochure within the Schedule of Benefits section with the exclusion towards the back.
2014 - 2015 School Year
HARD WAIVER STUDENT ENROLLMENT INSTRUCTIONS
If you are a full-time medical student you are automatically enrolled in this insurance Plan, unless proof of comparable coverage is furnished
- Annual Enrollment Deadline: 8/15/14
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.
Student Injury & Sickness plan,
Enrollment Instructions for Dependents Coverage
To 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.)
Open Enrollment Periods
IMPORTANT INFORMATION: Open Enrollment Periods for all Dependents and Students: If you have eligible Dependents in the fall or, are a student in the fall semester and eligible to purchase coverage and you choose not to enroll for coverage before the Fall Enrollment Deadline of *August 15, 2014, your Dependents or you, will not be eligible to enroll again until the start of next fall unless you experience a “Qualifying Life Event during the year. A Qualifying Life Event includes marriage, divorce, birth of a child or loss of coverage through no fault of your own (i.e. aging of your parents coverage).If your Dependents or you, experience a “Qualifying Life Event, you must submit proof of the event and enroll within 30 Days of the event, otherwise you will no longer be eligible to enroll for the remainder of the policy year.
Qualifying Life Event
If you did not enroll, or did not enroll your dependents (dependents of hard waiver or voluntary students) during your open enrollment period and have since lost coverage under your original plan, you or the dependents may qualify for a Qualifying Life Event, upon providing proof of involuntary loss of coverage and payment, within 30 days of losing coverage. (example: marriage, divorce, loss of job, etc) The enrollment form, check or money order and the letter of creditable coverage, must be received within 30 days of losing coverage. After 30 days, the student or dependents will no longer be eligible to enroll in the plan, until fall of the following school year.
FULL-TIME STUDENTS: DEPENDENTS ONLY ENROLLMENT FORM
- DEPENDENT ONLY ENROLLMENT FORM coming soon!