Roger Williams University
STUDENT HEALTH INSURANCE PLAN
Qualifying Life Event Enrollment Form
2024-2025 Academic Year
If you have a qualifying life event outlined below, you may qualify for special enrollment rights to enroll in the student insurance plan outside of the initial enrollment period.
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Required Documentation: loss of coverage letter that includes your name and your last day of coverage
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Deadline: 31 days from the last day of coverage in the prior plan
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Effective Date of Coverage: the first day without coverage in the prior plan
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Required Documentation:
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If moving to the US: Identification page of Passport and page with U.S. entry date stamp
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If moving within the US: travel documentation confirming a move to RI and documentation of active insurance coverage that does not provide coverage in RI.
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Deadline: 31 days from the entry into the US or move from the coverage area
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Effective Date of Coverage: date of entry into the US or move out of other plan's service area.
To access the form, go to the Roger Williams University login page by clicking on the link below. Note: New students enrolling at RWU can access the form once you receive your RWU student ID number, which will be included in a separate mailing once RWU receives your deposit.