New England Law | Boston
STUDENT HEALTH INSURANCE PLAN

Qualifying Event Enrollment Form
2025-2026 Academic Year 

Read all the information before starting the form.

The prorated cost will be added to your NEL tuition statement.

All qualifying events require supporting documentation. Your application cannot be processed if it does not include the correct documentation. Please wait until you have the appropriate documentation to submit your form. If you have questions about the documentation required, please contact UHP at 800-437-6448 before you submit your form. 

The coverage start date is your first day of coverage in the NEL student insurance plan, and it must coincide with your documentation. For example, if you are losing your other coverage, be sure to confirm your first day without coverage under your prior plan. Your enrollment cannot be processed if the application does not match the first day without coverage, as indicated on your supporting documentation. If you have questions, please contact your prior insurance company or UHP before submitting your application.

Eligible Life Events

• Required Documentation: loss of coverage letter that includes your name and your last day of coverage
• Effective Date of Coverage: the first day without coverage in the prior plan

• Required Documentation: If you were insured by a private insurance plan that no longer provides comprehensive benefits in MA, documentation is required to confirm the date the plan no longer provides comprehensive benefits in MA.  
• Effective Date of Coverage: the date you lost coverage in MA via your private insurance plan.