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Illinois Institute of Technology
STUDENT HEALTH INSURANCE PLAN

2025-2026 Spring Dependent(s) 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 January 16, 2026. 

Note, this form is for NEW spring students only.  If the student is currently enrolled in the plan and dependents suffered a loss of coverage, the Dependent Qualifying Event Enrollment form should be submitted.  Please email info@univhealthplans.com and request the dependent qualifying event enrollment form. 

Asterisk (*) denotes required field

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