UIC GLOBAL
STUDENT HEALTH INSURANCE PLAN

You have received your medical ID card.  In order to receive future communication from the insurance carrier and/or University Health Plans as well as access to online eligibility and claims lookup, please complete the following:

PLEASE FILL OUT THE REQUIRED FIELDS BELOW:

An asterisk * denotes a required field.

First Name: *
Middle Initial:
Last Name: *
Student ID:
Email Address: *
Local Address: *
Local Address (cont.):
Local City: *
Local State: *
Local Zip Code: *
Date of Birth: *  (MM/DD/YYYY)
Gender: *
 

Detailed information about the plan, including co-pays, deductibles and provider network can also be found on the left hand side of this page.