Butler University
STUDENT HEALTH INSURANCE PLAN
Annual Enrollment Form
2025-2026 Academic Year
TO CONTINUE THE ENROLLMENT PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW:
Student Health Plan
- Waiver Form
- Enrollment Information
- Qualifying Event Enrollment Form
- Insurance ID Card
- Confirmation of Coverage Letter
- Prescription Tier Structure
- 1095-B Form
- Pharmacy Locator
- Worldwide Travel Assistance