Rutgers Biomedical and Health Sciences

2018-2019 Student Health Insurance Plan
           VOLUNTARY FALL PART-TIME STUDENT          

ENROLLMENT FORM

PLEASE NOTE: If you are a Rutgers student with a 9 digit RUID#, you are at the wrong page to complete the enrollment form.  This enrollment is for RBHS students only.  Please go back by clicking HERE and select the left tab with the 9 digit RUID#.  If you are an RBHS student with sid# "A00..." please proceed.

Fall part-time students who are enrolled in a degree-seeking program at Rutgers and are taking at least one credit may purchase the Rutgers Biomedical and Health Sciences Student Health Insurance Plan on a voluntary basis.

Fall part-time students who participate in clinical experience are required to have health insurance coverage and will be charged for the RBHS student health insurance plan through their tuition bill.  Do not complete this form if this applies to you.

The Enrollment Deadline is September 30, 2018.


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

Asterisk (*) denotes required field

STUDENT INFORMATION

 
first name: *
last name: *
student ID: *
date of birth: * (MM/DD/YYYY)