2019-2020 Policy Year Waiver Form
(August 25, 2019 - August 24, 2020)

The Fall 2019 waiver deadline has passed.

Fall 2019 Waiver Appeal ProcessThe online waiver appeal form for students entering fall semester and missed the October 1, 2019 waiver deadline will be available October 3, 2019. If you missed the fall waiver deadline of October 1, 2019, you may submit a missed waiver deadline appeal for consideration. The deadline to submit a missed waiver appeal is December 6, 2019. You may only submit an appeal one time while a student at SVA. If you have used the SVA Student Health Insurance Plan since August 25, 2019, your plan will not be terminated and the fee will remain on your bill. If your Waiver Appeal is approved, you will be charged a Late Health Cancellation Fee of $200.

The Waiver Appeal Process is for Fall 2019 only. After submitting a waiver appeal form, you must ALSO submit a Spring 2019 waiver form which can be found here.

If you have any questions, please contact University Health Plans at 1-800-437-6448 or