The 2024 Spring dependent enrollment form deadline has passed. The dependent enrollment form for the 2024-2025 academic year will be available early July.
Student Health Plan
- Waiver Form
- Dependent Enrollment Form
- Qualifying Event Enrollment Form
- Insurance ID Card
- Confirmation of Coverage Letter
- Travel Assistance Services
- Prescription Tier Structure
- 1095-B Form
Optional Plans
Additional Information
The waiver form is no longer available.
The waiver appeal form is no longer available.