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American International College
STUDENT HEALTH INSURANCE PLAN

Spring Termination Request Form
2024-2025 Academic Year

Please Note: This is a Spring Termination Request form. This form is for students enrolled in annual coverage who meet the criteria below and would like to request termination for the spring coverage period. If you are a new spring student charged for the spring insurance premium, please choose the waiver form on the left.

Massachusetts Student Health Insurance Regulations allow students who paid for the Student Health Insurance Plan (SHIP) for the full 2024-2025 policy period to request termination for the spring coverage period if they are in one of the following situations:

  • Not returning to their college or university for the spring semester
  • Obtained coverage through MassHealth or a subsidized connector care plan on or before 1/1/2025

Only students in one of the two situations above can use this form. Students who are newly eligible for a private insurance plan or are not moving from Massachusetts are not eligible for a spring termination. They can continue to utilize the student health insurance plan through 7/31/2025.

Asterisk (*) denotes required field

 (MM/DD/YYYY)