Opt-Out Applications

Application Deadline

30 days from the official start date of your program

New and Returning Students

Every new student in an eligible program is charged the plan fee(s) and can opt out within 30 days of their program start date.

If this deadline is missed, you will be eligible to opt out next year within 30 days of your plan anniversary as a returning student.

If you leave the school for more than a year you are considered a new student for the purposes of this form.

things-to-considerThings to Consider
  1. You must be assessed the Health Insurance Fee and Dental Insurance Fee on your student account in order to opt out.
  2. You must provide Alternative Proof of Coverage through any of the following: your parents, spouse or common law partner, job, government, or band.
  3. A parents' insurance plan could cease to provide coverage when a dependent student turns either 18 or 21, or up to 25 if you are studying full-time at a recognized education institution.
  4. If you opt out of the dental plan, you are still considered to have access to dental insurance, which makes you ineligible for the Canadian Dental Care Plan (CDCP).
  5. You can coordinate two benefit plans to maximize your coverage, potentially reaching up to 100% coverage! Find out more Coordination of Benefits.
  6. Students with comparable coverage can choose to opt out of the health, dental, or both plans.
  7. Approval of the Benefit Plan Opt-Out application will result in the plan fee being refunded according to the school's policy.
  8. If you previously opted out, within the past four (4) years you will not need to complete a new opt-out request as your opt-out application normally carries forward for four (4) years unless you turns 25.
  9. A student's opt-out status will end on their 25th birthday unless evidence of their continued enrolment in an extended health and/or dental plan is provided to ccssplan@camosun.ca.
  10. NO EXCEPTIONS will be made if the deadline is missed. It is the student's responsibility to pay the plan's mandatory fees, should they miss the applicable opt-out deadline.

Health and Dental Opt-Out Form

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



Student Information

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