Get the free Student Injury and Sickness Insurance Plan Enrollment Form

This document is intended for undergraduate and graduate students to enroll in the student injury and sickness insurance plan at The University of Maine for the policy period from January 1, 2009

How to fill out student injury and sickness

How to fill out Student Injury and Sickness Insurance Plan Enrollment Form

1. Obtain the Student Injury and Sickness Insurance Plan Enrollment Form from the school or insurance provider website.
2. Fill out the personal information section with your full name, date of birth, and student ID number.
3. Provide your contact information, including your current address, phone number, and email address.
4. Indicate your program of study and the duration of your enrollment.
5. Review the coverage options available and select the plan that suits your needs.
6. Fill out the section regarding dependents, if applicable, providing their names and relationship to you.
7. Read and understand the terms and conditions of the insurance plan.
8. Sign and date the form to confirm your enrollment and acceptance of the terms.
9. Submit the completed form by the specified deadline, either online or through mail.

Who needs Student Injury and Sickness Insurance Plan Enrollment Form?

1. All enrolled students at institutions requiring health insurance coverage.
2. International students needing insurance for study abroad.
3. Students participating in programs that mandate insurance for medical emergencies.

For pdfFiller’s FAQs

What is Student Injury and Sickness Insurance Plan Enrollment Form?

The Student Injury and Sickness Insurance Plan Enrollment Form is a document used by students to enroll in a health insurance plan specifically designed to cover medical expenses related to injuries or illnesses while attending an educational institution.

Who is required to file Student Injury and Sickness Insurance Plan Enrollment Form?

Students who are enrolled in an educational institution and are required to have health insurance coverage, or those who wish to enroll in a specific student health insurance plan, are typically required to file this form.

How to fill out Student Injury and Sickness Insurance Plan Enrollment Form?

To fill out the form, students must provide personal information such as their name, contact details, student ID number, and select the coverage period. Additionally, they may need to provide details of any existing health insurance coverage and sign the form to acknowledge their enrollment.

What is the purpose of Student Injury and Sickness Insurance Plan Enrollment Form?

The purpose of the form is to facilitate the enrollment of students into a specific health insurance plan that covers injuries and sicknesses, ensuring they have access to necessary medical care while pursuing their education.

What information must be reported on Student Injury and Sickness Insurance Plan Enrollment Form?

The form typically requires information such as the student's full name, date of birth, student ID, contact information, type of coverage selected, and details regarding any pre-existing health conditions or current insurance coverage.