Ringling College of Art and Design
STUDENT HEALTH INSURANCE PLAN

Qualifying Event Enrollment Form
2024-2025 Academic Year

Read all the information before starting the form.

All qualifying events require supporting documentation. Your application cannot be processed if it does not include the correct documentation. Please wait until you have the appropriate documentation to submit your form. If you have questions about the documentation required, please contact University Health Plans at 833-251-1145 before you submit your form. 

The coverage start date is your first day of coverage in the Ringling College of Art and Design student insurance plan, and it must coincide with your documentation. For example, if you are losing your other coverage, be sure to confirm your first day without coverage under your prior plan. Your enrollment cannot be processed if the application does not match the first day without coverage, as indicated on your supporting documentation. If you have questions, please contact your prior insurance company or University Health Plans before submitting your application.

Eligible Life Events

Loss of Other Coverage:

• Required Documentation: Loss of coverage letter that includes your name and your last day of coverage
• Effective Date of Coverage: The first day without coverage in the prior plan

Living Away From Plan's Service Area:

• Required Documentation: If you were insured by a private insurance plan that no longer provides comprehensive benefits in Florida, documentation is required to confirm the date the plan no longer provides comprehensive benefits in Florida.  

• Effective Date of Coverage: The date you lost coverage in Florida via your private insurance plan.