University of Massachusetts - Dartmouth
STUDENT HEALTH INSURANCE PLAN
Spring Termination Request Form
2024-2025 ACADEMIC YEAR
Massachusetts Student Health Insurance Regulations allow students who paid for the Student Health Insurance Plan (SHIP) for the full 2024-2025 policy period to request termination for the spring coverage period if they are in one of the following situations:
- Not returning to their college or university for the spring semester
- Obtained coverage through MassHealth or a subsidized Commonwealth Connector Care plan on or before 1/1/2025
- Obtained coverage through a private insurance plan that is comparable to the UMassD SHIP on or before 1/1/2025. To be eligible, the plan must be a US-filed and approved, ACA (Affordable Care Act) compliant health insurance plan that provides emergency and non-emergency care in Massachusetts.
The Spring Termination Form Deadline is January 31, 2025.
TO CONTINUE THE WAIVER PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW:
