St. John’s University
2025-2026 Policy Year
Student Health Insurance Plan
Mandatory Student - Annual Waiver Form

Domestic Students Living ON Campus

THIS FORM IS FOR DOMESTIC RESIDENT STUDENTS ONLY. Eligible domestic students living on campus are automatically enrolled in the plan unless they can provide evidence of equivalent coverage satisfactory to St. John’s University by submitting a waiver by the posted deadline.

• If you are a commuter student, it is not necessary to complete this form.
   
• If you are an international student, DO NOT complete this form. For more information click HERE.
   

In order to successfully complete the below waiver form you will need to provide your Student ID number beginning with the letter "X". Please do not use the number that starts with "9". This will result in the waiver not posting to your student account. If you do not have the student ID number that begins with "X", please contact St. John's University Customer Service at 718-990-2000.