RHODE ISLAND COLLEGE
STUDENT HEALTH INSURANCE PROGRAM

2018-2019 Policy Period 
August 15, 2018 - August 14, 2019

Waiver Form


Undergraduate Students: If you are pre-registered in 9 or more credits at the time of the initial Fall (July 9, 2018) billing period, you are automatically enrolled in this plan and the fall insurance premium will be included on your tuition bill unless you fill out a waiver form.


Important: Please enter your 7-digit RIC Student ID number with the leading zero in the Student ID field below.  If you do not have this number, please contact the Rhode Island College Bursar's Office.

date of birth: (MM/DD/YYYY)
student ID: (7 digits including leading zeros)