AMERICAN INTERNATIONAL COLLEGE
STUDENT HEALTH PLAN

2020-2021 POLICY YEAR
Spring Termination Request Form

Please Note: This is a Spring Termination Request form. If you are looking to waive Annual coverage, go back and submit the annual waiver form.

Massachusetts Student Health Insurance Regulations allow students who paid for the Student Health Insurance Plan (SHIP) for the full 2020-2021 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 1/1/2021

Special Provision: Due to the COVID-19 pandemic, an additional spring termination provision has been added for the Spring 2021 coverage period. Students who were studying on-campus for the Fall Semester and will be remote for the Spring Semester can request a spring termination. Students must document that they maintained insurance coverage that meets the waiver requirements in the location in which the student will live for the spring semester.

Only students in one of the two situations and the special provision above can use this form. Students newly eligible for a private insurance plan or not moving from Massachusetts are not eligible for a spring termination and can continue to utilize the student health insurance plan through 7/31/2021.

Spring Termination Form Deadline January 31, 2021.