Creating the Extraordinary Student Experience

Important Forms

2019-20 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 2019-20 coverage period is August 17, 2020. 
  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:

Interim Coverage forms:

Interim eligibility is defined here

Member forms:

 

2018-19 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 2018-19 coverage period is August 12, 2019. 
  2. The policy year corresponds to the August-to-August academic year, not the calendar year.
  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:

Member forms: