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Before applying, please make sure that:

  • You meet the ELIGIBILITY definition of the plan
  • The plan suits your health insurance needs
  • You have fully read the Program Brochure

Coverage will be effective the date the correct premium is received by the Company or a representative of the Company or the effective date of the coverage period, whichever is later, unless otherwise stated in the Master Policy.

By proceeding to the next page, the student understands and acknowledges the following:

  1. He/She has carefully read the Program Brochure and elects to enroll as indicated on this enrollment card;
  2. He/She agrees to share their insurance enrollment information with their school;
  3. Rates are not prorated other than as listed on this enrollment card;
  4. He/She meets the eligibility requirements for this coverage as described in the Program Brochure; and
  5. If it is later determined that eligiblity has not been met, the company’s only obligation is to refund premium. PREMIUM WILL NOT BE REFUNDED EXCEPT FOR INELIGIBILITY OR ENTRANCE INTO THE ARMED FORCES.