The 2023-2024 policy year enrollment cofirmation deadline has passed. This form is no longer available. If you are an eligible student for fall 2023 semester and took no action to confirm enrollment or waive, you willl be automatically enrolled in the Plan.
The spring 2024 policy period waiver form will be available in early November 2023.
If you previously submitted a waiver form for the 2023-2024 policy year and have lost or will be losing your other insurance coverage, you may qualify for special enrollment rights. You must contact University Health Plans at email@example.com or 833-251-1136 within 60 days of the date you lost coverage to enroll.