Instructions:

If you are Waiving School Health Insurance for the Next Year:

•  Print and fill out the attached Waiver Form (it is a Word Document and can be filled out on your computer and saved for your records). 

Submit the Waiver Form to the Office of Student Affairs (Joe Oppedisano, Sue Kaelin, Ivie Martinez or Grace Dobbyn).  Deadline for Waiving is Friday, August 1, 2008.  You may also fax your form to the Office at 212.263.0520.

•  Early in the fall semester, the Bursar Office will be notified about waivers and will adjust those student's bills accordingly.  ALL students are expected to make an effort to review their bills early in the fall semester to ensure that the appropriate charges are reflected.

•  The next open enrollment period will be January 2009.  Waiving now will be in effect for the entire year (9/1 – 8/31), unless enrolling at the next open enrollment period for the spring semester.

If you are Enrolling in the School's Health Insurance for the Next Year:

•  For students wishing to enroll in United Health, the Enrollment Form is included on this site.  Print the Enrollment form and complete the required information in sections 1, 2, 5, & 7 (your signature).  This includes students wishing to change coverage (i.e. family to individual or individual to family, or to add dependents).

•  Indicate your local address in order for your ID card to be mailed to the correct location and for billing purposes. 

EVEN IF YOU ARE ALREADY ENROLLED, YOU MUST COMPLETE A NEW ENROLLMENT FORM IN ORDER FOR THE BENEFITS OFFICE AND UNITED TO HAVE YOUR CURRENT ADDRESS ON FILE , AND TO HAVE A FORMAL RECORD OF YOUR DESIRE TO ENROLL FOR THE 2008-2009 ACADEMIC YEAR.  Submit your completed form to the Office of Student Affairs by Friday, August 1, 2008 .  You may also fax your form to the Office at 212.263.0520.

Additional Notes:

•  If you need to see the Summary of Benefits before making a decision, please visit www.med.nyu.edu/studentaffairs/resources to view the current Benefits Summary.  The benefits may change slightly for the 2008-2009 academic year.  Student will be notified of any changes as soon as they are determined. 

•  If you are currently away, or have some other circumstance that will hinder your ability to submit either a waiver or enrollment form by the deadline, please let the Office of Student Affairs know as soon as possible so that appropriate arrangements can be made.

•  STUDENTS WHO DO NOT SUBMIT ANYTHING BY THE DEADLINE OF AUGUST 1 ( AND WHO HAVE NOT MADE ARRANGEMENTS WITH THE OFFICE OF STUDENT AFFAIRS) WILL BE AUTOMATICALLY ENROLLED IN UNITED HEALTH AND BILLED ACCORDINGLY – NO EXCEPTIONS.

Please feel free to contact the Office of Student Affairs or Rebecca Gittens in the Benefits Office at Rebecca.gittens@nyumc.org with any questions regarding the above process.