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Sarah Lawrence College
STUDENT HEALTH INSURANCE PLAN

Qualifying Event Enrollment Form
2024-2025 Academic Year 

A qualifying life event makes you eligible for special enrollment rights to enroll in the student health insurance plan outside of your initial eligibility period. 


Loss of Coverage
  • If your other insurance coverage has recently ended or is about to end
  • If your plan no longer includes Bronxville, NY, in its service area.

Required Documentation: You must provide a loss of coverage letter that includes the student's name and specifies the date the coverage ends, or documentation showing that the plan no longer covers the student in Bronxville, NY.


Moving to School
  • If the student was studying abroad or outside of Bronxville, NY, during the fall semester, they may enroll in spring coverage upon returning to campus for the spring semester.

Required Documentation: Provide documentation or a letter confirming the location where the student studied during the fall semester.


The deadline to complete enrollment is 31 days from the date of the qualifying event.

Asterisk (*) denotes required field

STUDENT INFORMATION

 (MM/DD/YYYY)