RUTGERS UNIVERSITY

2017-2018 Student Health Insurance Plan
SPRING PART TIME STUDENT ENROLLMENT FORM

Part time students who are registered for online classes only are not eligible to enroll in the Student Health Insurance.

NOTE: YOU WILL NEED TO ENROLL AGAIN FOR COVERAGE BEGINNING AUGUST 15, 2018 IF YOU REMAIN AN ELIGIBLE STUDENT.

 

DEADLINE: Spring enrollment must be submitted by February 2, 2018.

To continue the enrollment process, please fill out the required fields below:

 

date of birth: (MM/DD/YYYY)
student ID: