University of Delaware
STUDENT HEALTH INSURANCE PLAN
Qualifying Event Enrollment Form - For Contracted Graduates
2024-2025 Academic Year
A qualifying event is an event such as losing health coverage, getting married, having a baby, or entry into the USA. These changes can make you and/or your dependents eligible for a special enrollment period, allowing you to enroll in the student health insurance outside the open enrollment period.
Eligibility: All full-time domestic undergraduate students (12+ Credits), international students on an F1, F2, J1 or J2 visa, contracted graduate students, and full-time domestic graduate students (9+ Credits). Eligible dependents for this plan include a legally married spouse, civil union partner, and children under the age of 26. Domestic Partners are not eligible for the plan.
You can use this form to enroll you and/or your eligible dependents in the UD Plan for coverage beginning prior to 6/1. Please contact University Health Plans at 833-251-1127 for eligibility if you have a qualifying event not listed below or an enrollment occuring after 6/1.
Loss of Other Coverage (losing health coverage through employer, parent's plan, or Medicaid)
Changes in Household (getting married or divorced, having a baby or adopting a child, or death in the family)
Changes in Residence (entry into the US or moving out of existing coverage area)
All qualifying events require documentation to provide proof of your qualifying event. If you have questions about the documentation required, please contact University Health Plans at 833-251-1127 before you submit your enrollment form.
Enrollment Deadline: The qualifying event enrollment form, payment, and required documentation must be received within 31 days from the qualifying event date.
