UNIVERSITY OF DELAWARE
STUDENT HEALTH INSURANCE PLAN
2018-2019 POLICY YEAR

SUMMER ENROLLMENT FORM

This coverage period is available to students who are registered for courses during Summer 2019 and were neither enrolled in nor waived out of the UD Student Health Insurance Plan (UD Plan) for any part of the Fall 2018 or Spring 2019 coverage periods. If you have questions about your Summer 2019 eligibility, please first contact University Health Plans at info@univhealthplans.com or 800-437-6448.


Students who are eligible to purchase the Summer 2019 coverage can elect to purchase the UD Plan by completing this form and submitting payment online with a credit card. Students may also add their dependents to their Summer 2019 with this form.

Summer 1 Plan Deadline
Summer 1 Enrollment Forms received by University Health Plans (UHP) with the full premium payment by midnight on 6/14/19 will be made effective as of 6/1/19. The Summer 1 enrollment deadline is June 14, 2019.

Summer 2 Plan Deadline
Summer 2 Enrollment Forms received by University Health Plans (UHP) with the full premium payment by midnight on 7/14/19 will be made effective as of 7/1/19. The Summer 2 enrollment deadline is July 14, 2019.

Summer 3 Plan Deadline
Summer 3 Enrollment Forms received by University Health Plans (UHP) with the full premium payment by midnight on 8/14/19 will be made effective as of 8/1/19. The Summer 3 enrollment deadline is August 14, 2019.

Please Note: The payment made to UHP for the Student Health Insurance Plan is NOT related to the Student Health Services fee charged to the student’s account at UD.


If you have read the information above and wish to continue to the Enrollment Form, complete the fields below.

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STUDENT INFORMATION

 
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