UNIVERSITY OF MASSACHUSETTS - LOWELL
STUDENT HEALTH INSURANCE PLAN

Spring Dependent Enrollment Form
2024-2025 Academic Year

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.

The deadline to complete the Spring 2024-2025 Dependent Enrollment Form is March 14, 2025. 

Your student ID# must be entered as an 8-digit number