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Massachusetts College of Liberal Arts
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
     

The Spring Termination Form Deadline is January 31, 2025. 

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

Asterisk (*) denotes required field

 (MM/DD/YYYY)