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Illinois Institute of Technology
STUDENT HEALTH INSURANCE PLAN

2026-2027 Annual Dependent Enrollment Form 
 

If you are enrolled in the Student Health Insurance Plan (SHIP), you may purchase the plan for your eligible dependents (lawful spouse, civil union partner, or children) through this online form. The deadline to enroll your dependents August 25, 2026. 

Asterisk (*) denotes required field

 (MM/DD/YYYY)