Saint Joseph’s University
STUDENT HEALTH INSURANCE PLAN
2024-2025 Academic Year
Qualifying Event Enrollment Form
A qualifying life event is a situation that makes you eligible for special enrollment rights to enroll in coverage outside of your initial eligibility period. Eligible students and dependents may enroll in coverage if they are in one of the following situations.
Eligibility will be verified with SJU before the coverage effective date. The deadline to complete enrollment is 30 days from the date of the qualifying event.
LOSS OF COVERAGE
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If your other insurance coverage recently ended or will end soon
- if you are moving away from your plan's service area or your plan's service area no longer includes the location you live while attending school or in a clinical placement
Required Documentation:
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A loss of coverage letter that confirms the student and/or dependent(s) name and identifies the date the coverage will end.
- Documentation that the plan will no longer cover the area where the student/dependent lives.
- Documentation that the student is moving to a new location and documentation that the plan does not include the new geographical area
The effective date of new coverage is the first day without coverage under the prior plan.
CHANGE IN HOUSEHOLD
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Birth or adoption of a child
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Marriage to the student
- International spouse entering the US
Required Documentation:
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Birth/adoption certificate
- Marriage certificate
- Passport stamp or I94
The effective date of new coverage is the date of the change in household.
Eligiblity will be verified with SJU before enrollment is processed
