Creating the Extraordinary Student Experience

Important Forms

 

2017-18 Forms __________________________________________

Notices:

  1. Students cannot submit petitions for a policy year that has already ended. The deadline to submit a Petition to Waive for any 2017-18 coverage period is August 13, 2018. 
  2. The policy year corresponds to the August-to-August academic year, not the calendar year. See dates here.
  3. If you experience a Qualifying Event and wish to modify an existing selection or waiver, submit the Coverage Status Change form within 31 days. Do not submit a Petition to Waive or Petition to Enroll.
  4. With the exception of Qualifying Events, an SHI Benefits Plan selection stays in effect until the end of the policy year -- assuming academic eligibility is maintained -- and students cannot modify or drop that selection term by term. For example, if a student selects the SHI Benefits Plan for autumn, they cannot waive it for spring/summer. 

Change forms:

  • 2017-18 Petition to Waive (USE IF: You are an International student who meets waiver criteria OR You are a domestic student who missed the Select/Waive deadline OR My Buckeye Link would not let you waive.) 
  • 2017-18 Petition to Enroll (USE IF: You missed the Select/Waive deadline or have special academic circumstances.)
  • 2017-18 Coverage Status Change (USE IF: You wish to modify your existing selection or waiver due to a Qualifying Event. Note: If you are a member of the armed forces who is required to interrupt your academic year for service, please contact us for assistance.) 

Documentation forms:

Member forms:

Interim forms: 

Interim eligibility is defined here