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Emerson College
STUDENT HEALTH INSURANCE PLAN

Voluntary Enrollment Form
2024-2025 Academic Year

Matriculated undergraduate and graduate students enrolled in less than 75% full-time and not in a short-term or online program must complete this form if they wish to purchase the Student Health Insurance Plan (SHIP). Students in short-term or online programs or who do not attend classes during the first 45 days of the semester are not eligible for the student insurance plan. 

Health insurance charges are automatically removed when students drop to fewer than 9 undergraduate or 6 graduate credits within the first 45 days of the coverage period. These students must also submit a request for coverage to remain enrolled in the Student Health Insurance Plan.

Once your enrollment form is received and eligibility is confirmed, the student health insurance fee will be added to your student account.

The Emerson Student ID begins with E and is followed by 8 digits.

Asterisk (*) denotes required field

STUDENT INFORMATION

 (MM/DD/YYYY)