THE NEW SCHOOL
STUDENT HEALTH INSURANCE PLAN
SPRING 2025 POLICY PERIOD
DEPENDENT ENROLLMENT FORM
Effective August 20, 2024 the SHIP insurance carrier will change to Aetna Student Health
Dependent coverage, if elected, begins and ends with the student’s coverage and must be purchased at the same time the student enrolls in the plan. If an enrollment form is submitted and the dependent is not eligible, it will not be processed.
This form is for dependents of new spring students only. If you were enrolled in the Student Health Plan for fall 2024 and did not enroll your dependents by the fall deadline, you are not eligible to enroll them in the Plan for spring. If an enrollment form is submitted and the dependent is not eligible, it will not be processed.
If your dependent has experienced a qualifying life event (ie. loss of other coverage, recent marriage, birth, etc.) please contact University Health Plans at info@univhealthplans.com or 833-251-1129.
The deadline to complete this enrollment form is February 10, 2025.
PLEASE FILL OUT THE REQUIRED FIELDS BELOW TO CONTINUE THE DEPENDENT ENROLLMENT PROCESS:
