Saint Joseph's University
STUDENT HEALTH INSURANCE PLAN

2025-2026 POLICY YEAR
Spring Termination Request Form

Please review the submission instructions closely. If you are not eligible for a spring termination, or if your request is incomplete or submitted incorrectly, it will not be processed.

IMPORTANT: This form is only for students who will not be attending Saint Joseph's University for the Spring 2026 semester

• UHP will confirm your scheduled graduation or withdrawal with SJU before approving and processing your termination request. This verification may take some time, but if your request is submitted before the end of the year, it should be completed by the end of December.
• Students who are returning will remain enrolled in the annual coverage period.

Important information for Spring Termination Requests:

• Once your termination is approved, you cannot re-enroll in the 2025-2026 SHIP. 
• Your request will be denied if you have claims on file after 12/31/25.
• You will receive an email confirmation when your spring termination is approved or denied.
• If your request is approved, your coverage will end 12:01 AM 1/1/26, and the charge on your student account will be adjusted to $1,071.00
• If this results in an overpayment, you can contact SJU for a refund.

The Deadline to Submit a Spring Termination Request is 1/23/26