Family Add-On Applications

Application Deadline

Lifestyle Change Add-On

Students who have experienced a significant lifystyle change (eg. marriage, birth of a child, etc.) may add on their family members to the plan up to 30 days after the Lifestyle Change.

Before completing this form you must provide documentation confirming your change of circumstances and the date on which they occurred by emailing ccssplan@camosun.ca

If this deadline is missed, you will be eligible for an Anniversary Add-On.

New and Anniversary Add-Ons

New students are eligible to add family members onto their plan up to 30 days from their program start date.

Returning students have 30 days from the anniversary of your program start date to submit the Family Add-on form.

If this deadline is missed, your family members will not be eligible for benefits, and you will not be eligible to add them on until next year, following the previous guidelines.

things-to-considerThings to Consider
  1. You can only add as a dependent to your Student Benefits Plan your spouse, common-law partner or underage children. Parents, grandparents, and siblings do not qualify as dependents.
  2. Your dependents would be covered under your Student Benefits Plan, which means they would be entitled to the benefits you have through your plan.
  3. Approval of the Health and Dental Plan Family Add-On application will result in the Family Add-On Fees being assessed. You will receive an email informing you of how to pay the fees.
  4. The Family add-on fees cover 12 months of coverage; add-ons must be renewed each year if you wish to keep your family covered.
  5. NO EXCEPTIONS will be made if the application or payment is missed. It is the student's responsibility to check their emails regarding the status of the application or deadlines.

Health and Dental Family Add-On Form

Please complete all information on the family add-on form and we will process your application as soon as we can.



Student Information

Sex
Date of Birth
Phone Number
Program Start Date

Once your form is submitted you will receive an email from donotreply@gallivan.ca confirming your submission.

Please do not reply to this email. Retain a copy of it for your records.

Questions? Please contact your Plan Support Office: ccssplan@camosun.ca