Elms College
Student Health Insurance Plan

Annual Waiver Form
2024-2025 Academic Year

Does your current health plan...

....provide coverage while in the area of the Elms College campus? Many out-of-sate HMO, EPO, and Medicaid plans provide coverage for emergency treatment only while out-of-area of the local plan area.

...cover you as long as you are a registered student at Elms College? Most employer plans drop dependents at a certain age or if a parent has a job change.

...cover mental health services? Many employer-sponsored plans provide very limited coverage for mental health services.

...provide coverage anywhere in the world, including medical evacuation and repatriation benefits while the student is away from campus for academics, research, work, or vacation? Many employer-sponsored plans will only provide coverage while in the United States, and most do not include any medical evacuation or repatriation benefits.

...include prescription drug coverage and a nationwide network of member pharmacies? Many employer-sponsored plans do not provide prescription drug coverage or only very limited benefits available at certain local pharmacies.

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

Please enter your 7 digit Elms Student ID Number with the leading zero in the Student ID field below