Insurance - Forms

The 2018-19 Waiver/Enrollment Period is Open

 

ALL Students Must Waive or Enroll Annually. 

 

The Waiver/Enrollment Period for Fall, 2018 opens August 1, 2018 and continues to Census Day, September 5, 2018.

Waiver and Enrollment forms are completed online through the student's Trailhead account.  (Instructions below)

 

Instructions for Using the SHIP Online Enrollment/Waiver Process:

Login to Trailhead and click on the Self Service button.  Click on the Student link.
Click on the Registration link.
Near the bottom of the list, right click on "Enroll/Waive in Student Health Insurance Plan (SHIP)" and choose "Open in New Tab/Window."
This should bypass any pop-up blocker you might have.
The page that displays is Academic Health Plan’s Enrollment/Waiver page.  Follow the instructions on the page to complete your enrollment/waiver.

If you are ENROLLING:

The sooner you enroll, the better! This will get your information into all systems so that your coverage will be fully active on the plan start date.
If you choose to enroll by clicking the green button, you will be prompted to read the Terms and Conditions, and enter your initals
If you choose to default enroll, it may be mid-September before you are fully activated in the system, which could result in delay of claims processing and prescription coverage.

If you are Waiving:

If you choose to waive by clicking the red button, you will be prompted to attach proof of insurance
Once your proof of insurance is uploaded, complete the Student Information Chart
Electronically sign and click Submit Waiver.  Waiver will be processed within five to seven business days.  It is the student’s responsibility to follow up on their waiver status

Waivers can take 5-7 days to process, and you may be asked for additional supporting information.   You will always see the charge for the SHIP on your account, and when the waiver is processed, you will see a corresponding waiver credit.

If you encounter problems or have questions, contact the Student Health Benefits Coordinator via email ship@mines.edu.

Students Must Waive or Enroll Annually.  You will need to waive or enroll for Fall, 2018 if you are registered for Fall semester.  Students have until Census Day to waive.

 Rates for the 2018-19 Academic Year

Annual  $2400 (billed $1200 Fall and $1200 Spring Semester--coverage 8/1/18-8/1/19)

Spring/Summer 2019 $1400 (coverage 1/1/19-8/1/19)

Summer 1, 2019 $533 (coverage 5/13/19 to 8/1/19)

Summer 2, 2019  $258 (coverage 6/24/19 to 8/1/19)

Please note: Dependent coverage is not available through the Student Health Insurance Plan.

Summary of Benefits for the SHIP 2018-19PDF versionText only version

Summary Brochure and Cost for the SHIP 2018-19PDF versionText only version

Formulary for the SHIP 2018-19PDF versionText only version

Summary of Benefits for the SHIP 2017-18PDF versionText only version

Summary Brochure and Cost for the SHIP 2017-18PDF versionText only version

Online Waiver/Enrollment Instructions