UNIVERSITY OF DELAWARE
STUDENT HEALTH PLAN
2015-2016 POLICY YEAR

MANDATORY STUDENT WAIVER FORM
(ANNUAL: 8/15/15-8/14/16)

Students who fall into one of the categories listed below are labeled as “Mandatory” [with regard to the UD Student Health Plan (UD Plan)].

  • Undergraduate students taking 12+ credits
  • Non-contracted graduate students taking 9+ credits
  • Contracted graduate students (including sustaining)
  • International students on F1, J1 or J2 visas

Students who are considered Mandatory for the Fall 2015 Semester will be automatically charged for the UD Plan on their student accounts for the Fall Semester and again for the Spring Semester [if their student status remains unchanged (i.e. Mandatory vs. Voluntary)].

Fall 2015 Mandatory Students who have other comparable coverage (click here for key requirements of a comparable plan) and do not want to be enrolled in the UD Plan must submit this online Waiver Form by the deadline of 9/15/15. This is the only way to request the removal of the UD Plan charge from a student’s account. Submitting the Waiver Form will remove the charge for the Fall 2015 UD Plan and will cause the Spring 2016 UD Plan charge to not appear on the student's account.

A student who is eligible to be automatically charged for the UD Plan for the Fall 2015 semester and does not submit a Waiver Form by the deadline of 9/15/15 will be responsible the UD Plan charges placed on their student account during the 2015-16 Academic Year. 
 
Please Note: The UD Plan charge appears on the student account as “Health Insurance for Students” and is NOT related to the Student Health Services fee.


If you have read the information on this page and would like to begin the Waiver Form process, submit your Student ID and Date of Birth below.

date of birth: (MM/DD/YYYY)
student ID: