Student / Dependent Enrollment

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 .   

2015 - 2016 School Year

HARD WAIVER STUDENT ENROLLMENT INSTRUCTIONS
If you are a…
International, Pharmacy or Nursing and College of Health Sciences student,
you are automatically enrolled in this insurance plan unless proof of comparable coverage is furnished. You can also enroll yourself now by clicking "Enroll Now" below to avoid receiving future reminders.

  • Annual Enrollment Deadline: 9/6/15
  • Spring/Summer Enrollment Deadline: 2/28/16
 
ENROLL NOW


 
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 but your non-school sponsored coverage is being terminated due to a Qualifying Life Event and you are now looking to enroll in the Student Injury & Sickness plan:

Please
 CONTACT US
 

DEPENDENTS ENROLLMENT INSTRUCTIONS

Hard Waiver Students who do enroll may also insure their eligible dependents.

  • Annual Enrollment Deadline: 9/6/15
  • Spring/Summer Enrollment Deadline: 2/28/16
 

ENROLL BY MAIL



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.

 

 
 
If your Dependents non-school sponsored coverage is being terminated due to a Qualifying Life Event and you are now looking to enroll in the Student Injury & Sickness plan or If you have any questions about the enrollment process, please call 800-505-4160 or
 
 

 

  • Dependent Only Enrollment ForM COMING SOOn!

 


 

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 Annual Enrollment Deadline of *September 6, 2015, 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.
*For new Dependents or new or renewing students in the spring semester, your open enrollment deadline is February 28, 2016
 

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.

 

 



 

2014 - 2015 School Year

PLEASE NOTE: If you do not enroll for the year during the annual open enrollment period, you will not be able to enroll later during the 2014-2015 school year without experiencing a “Qualifying Life Event”. This means that the loss of coverage is no fault of your own or the policyholders (i.e. you get married or become too old to be on a family plan). You will be eligible to enroll within thirty days of this “Qualifying Life Event.” After thirty days, you will no longer be eligible.

 

HARD WAIVER STUDENT ENROLLMENT INSTRUCTIONS
If you are a…
International, Pharmacy or Nursing Student
you are automatically enrolled in this insurance plan unless proof of comparable coverage is furnished. You can also enroll yourself now by clicking "Enroll Now" below to avoid receiving future reminders.

  • Annual Enrollment Deadline: 9/8/14
  • Spring/Summer Enrollment Deadline: 2/28/15

 

ENROLL NOW



 

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 but your non-school sponsored coverage is being terminated due to a Qualifying Life Event and you are now looking to enroll in the Student Injury & Sickness plan:


Please  CONTACT US
 


DEPENDENTS OF HARD WAIVER STUDENTS ENROLLMENT INSTRUCTIONS
Hard Waiver Students who do enroll may also insure their eligible dependents.

  • Annual Enrollment Deadline: 9/8/14
  • Spring/Summer Enrollment Deadline: 2/28/15 

 

  •        ENROLL BY MAIL


    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.
     
     

If your Dependents non-school sponsored coverage is being terminated due to a Qualifying Life Event and you are now looking to enroll in the Student Injury & Sickness plan or If you have any questions about the enrollment process, please call 800-505-4160 or
 

CONTACT US


VOLUNTARY STUDENTS AND THEIR DEPENDENTS ENROLLMENT INSTRUCTIONS
If you are a…
Degree seeking student taking 6 or more credit hours
you are eligible to enroll online or with an enrollment form. Voluntary Students who do enroll may also insure their eligible dependents. Please see instructions below to enroll.
 

  • Annual Enrollment Deadline: 9/5/14
  • Spring/Summer Enrollment Deadline: 1/14/15
     

 

  • ENROLL ONLINE


    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.


     
  • ENROLL BY MAIL


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 period start date for the coverage period you enrolled.

If your Dependents non-school sponsored coverage is being terminated due to a Qualifying Life Event and you are now looking to enroll in the Student Injury & Sickness plan or If you have any questions about the enrollment process, please call 800-505-4160 or
 

CONTACT US

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

We are always happy to help in anyway.