Ithaca College
STUDENT HEALTH INSURANCE PLAN

2018-2019 POLICY YEAR
Annual Term Waiver Form

This form is for all new incoming students and returning students for the Fall 2018 Term.

Ithaca College requires all matriculated undergraduate and graduate students to have health insurance. All students who are required to have health insurance are initially charged for the SHIP.

Eligible students who have other health insurance coverage (i.e. under a parent’s or employer’s plan) and do not want to be enrolled in the student health insurance plan must submit an online waiver documenting their other coverage prior to the posted deadline each academic year. Once a waiver form is successfully submitted, the insurance charge is removed from the student’s account within approximately 10-15 business days.

The waiver deadline for the Annual Term is August 10, 2018. Students who miss the waiver deadline will be enrolled in the student health insurance plan and held responsible for paying the associated premium.

 


TO CONTINUE THE WAIVER PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW:

Please Note: You must enter your Ithaca College email address below. Entering your personal email address will not allow you access to the waiver form. You must activate your Ithaca College Netpass/e-mail account prior to completing this process.

date of birth: (MM/DD/YYYY)
student ID:
email address: