RUTGERS UNIVERSITY

2020-2021 Student Health Insurance Plan
FULL-TIME FALL WAIVER FORM

All full-time Undergraduate Students taking 12 or more credit hours and all full-time Graduate Students taking 9 or more credit hours* are required to have comprehensive Health Insurance each semester.  Student insurance eligibility may be affected if an enrollment status change occurs (part-time to full-time or full-time to part-time).  Students must actively attend classes for at least 31 days after the date for which coverage period is purchased.

*full-time graduate students as defined by the student’s department could require you to be registered for 12 credits, example: Rutgers Business School, Rutgers Law School.

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 form documenting their other coverage prior to the posted deadline each semester. Once the term bills are processing, please allow approximately 4 business days for the insurance charge to be removed.

DEADLINE:SEPTEMBER 15, 2020.

IF YOU HAVE ALREADY BEEN ENROLLED AND HAVE INCURRED CLAIMS UNDER THE STUDENT HEALTH INSURANCE PLAN, YOUR COVERAGE CANNOT BE CANCELLED AND YOU WILL BE RESPONSIBLE FOR THE FULL PREMIUM.

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

 (MM/DD/YYYY)