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University of Massachusetts - Lowell
STUDENT HEALTH INSURANCE PLAN

Spring Termination Request Form
2023-2024 ACADEMIC YEAR

Massachusetts Student Health Insurance Regulations allow students who paid for the Student Health Insurance Plan (SHIP) for the full 2023-2024 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 Commonwealth Connector Care plan on or before 1/1/2024
  • Obtained coverage through a private insurance plan that is comparable to the UML SHIP on or before 1/1/2024. To be eligible, the plan must be a US-filed and approved, ACA (Affordable Care Act) compliant health insurance plan that provides emergency and non-emergency care in Massachusetts.

The Spring Termination Form Deadline is March 8, 2024. 

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

Asterisk (*) denotes required field

 (MM/DD/YYYY)