If you've previously opted out of the plan(s) you may be eligible to opt back in up to 30 days after losing your alternative coverage.
Before completing this form you must provide documentation such as a letter from the alternate insurance carrier or the employer stating the student's name, insurance carrier's name and policy number and the loss of coverage date by contacting your Plan Support Office.
If this deadline is missed, you will be automatically opted back in for the fall semester.