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Roger Williams University

Qualifying Life Event Enrollment Form
2023-2024 Academic Year

If you have a qualifying life event outlined below, you may qualify for special enrollment rights to enroll in the student insurance plan outside of the initial enrollment period. 

Loss of Other Coverage:
  • Required Documentation: loss of coverage letter that includes your name and your last day of coverage
  • Deadline: 31 days from the last day of coverage in the prior plan
  • Effective Date of Coverage: the first day without coverage in the prior plan
Change in Residence (entry into the US or moving from coverage area)
  • Required Documentation:
    • If moving to the US: Identification page of Passport and page with U.S. entry date stamp
    • If moving within the US: travel documentation confirming a move to RI and documentation of active insurance coverage that does not provide coverage in RI. 
  • Deadline: 31 days from the entry into the US or move from the coverage area
  • Effective Date of Coverage: date of entry into the US or move out of other plan's service area. 

To access the form, go to the Roger Williams University login page by clicking on the link below. Note: New students enrolling at RWU can access the form once you receive your RWU student ID number, which will be included in a separate mailing once RWU receives your deposit.

Roger Williams University Login