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* Student ID is not a required field.
* If you don't know your University Email address, you may enter your personal email address instead.
Please choose your insurance coverage:
*For incoming students and continuing students enrolling during the Open Enrollment period (8/1/2017 - 8/31/2017), the requested effective date will be 08/01/2017.
*For continuing students enrolling outside of an Open Enrollment period, as a result of an involuntary loss of other coverage, the requested effective date will be the date you lost other coverage.
If you have any extra documents you would like us to have, please upload them here. Only .doc, .docx and .pdf files are accepted. Up to two documents may be uploaded. Each file may be no larger than 10 Megabytes.