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Dependent Enrollment Form

Domestic Partnership Form

Claim Inquiry/Satisfaction Survey

Major Medical Insurance/Short Term Insurance

This year we are again offering a program of Accident and Sickness Insurance for our students. The need for protection against unexpected and frequently high medical expenses, which may be incurred as a result of accident or sickness, is obvious. These expenses can seriously deplete the financial resources earmarked for educational purposes.

We hope you will consider this plan carefully. If you have no other coverage, covered expenses are payable to the limit of the Policy. If other coverage exists, covered expenses are payable in excess of your other insurance. Deductibles, exclusions, and out of pocket expenses not covered under your own policy could be paid under the school insurance.

Coverage starts on September 1, 2005, or the date of enrollment, if later. Coverage continues to September 1, 2006. All students will be automatically enrolled in the plan unless a waiver card is completed at the Admissions Office. The annual premium is $235. Dependent enrollment cards may also be obtained from the Admissions Office.

Once enrolled, a student may not cancel the insurance. Coverage continues until the Policy expires.