Enrollment

The Fall open enrollment period for the 19-20 academic year is 6/18/19 – 9/13/19.

PLEASE NOTE: Enrolling in this plan will cover you from August 15, 2019 through August 14, 2020. The enrollment and waiver process is completed on an annual basis, which means that if you are a full-time undergraduate student, you will be required to go through this process each academic year.

Domestic Students Only:

Enrollment Activation

International Students (F1 and J1 Visas) Only:

Enrollment Activation

Undergraduate students who wish to enroll a spouse and/or child, please complete the appropriate form below.

Enrollment Form to Enroll Dependents Only

Graduate students who wish to enroll, or for those wanting to enroll a spouse and/or child, please complete the appropriate form below.

Graduate students have the option to charge their premium to their bursar account or to pay directly to Academic HealthPlans. Only the student premium can be charged to Bursar account, all dependent premiums will be paid directly to Academic HealthPlans.

Enrollment Form to Enroll Graduates and/or Their Dependents

Qualifying Events Enrollment Form

Qualifying Events Enrollment Form - Use only for a life event (aging off parent’s plan, marriage, divorce, newborn, adoption of child). Supporting documentation is required.

Add-On Coverage Options

These services are not administered by Academic HealthPlans.