SUFFOLK UNIVERSITY

STUDENT HEALTH INSURANCE PLAN
2021-2022 ACADEMIC YEAR
WAIVER FORM

 

According to Massachusetts State Law and Suffolk University policy (Mandatory Health Insurance Coverage Institutions of Higher Education), every institution of higher education shall require all full-time and part-time students, defined as at least 75% of full time academic program, enrolled in a certificate, diploma or degree-granting program to participate in a qualifying student health insurance program or in a health benefit plan with comparable coverage as defined in 114.6 CMR 3.05(2). Suffolk students must annually submit a waiver form if they have comparable health insurance provided by a U.S. based carrier.

Eligible students who have other health insurance coverage (i.e. under a parent’s or employer’s plan) and do not want to be enrolled in the SHIP must submit an online waiver form documenting their other coverage prior to the posted deadline each academic year. Once a waiver form is successfully submitted, the insurance charge is removed from the student’s account within approximately 7 business days.

Students who miss the fall waiver deadline September 30, 2021 will be enrolled in the Suffolk Student Health Insurance Plan and held responsible for paying the associated premium.

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

 (MM/DD/YYYY)