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Principia College
STUDENT HEALTH INSURANCE PLAN

Annual Waiver Form
2024-2025 Policy Period

Please remember the following:

  • The waiver process is annual. You must make a selection before the beginning of the first semester of each academic year in which you are registered.
  • Principia College will review all waivers in order to ensure compliance with Principia College waiver policy requirements. Please be sure to have a copy of your insurance policy as you may be asked to provide this documentation.
  • Students must provide a copy of the front and back of their insurance ID cards with their insurance waiver form. Your submitted waiver will be audited and will not be processed until your receive a second email confirming the waiver was approved. 

TO CONTINUE THE WAIVER PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW:

 

Asterisk (*) denotes required field

 (MM/DD/YYYY)