Enrollment Forms and Policy Brochures
Students and dependents voluntarily enrolling in the Student Health Insurance must submit a completed enrollment form prior to the posted Open Enrollment Deadline each semester. (Fall & Spring=1 year)
Voluntary enrollment does not automatically continue from the previous semester.
Students must be registered for at least (1) Summer Semester credit hour through any OU campus to be eligible to enroll, unless they are enrolling due to a Qualifying Life Event (QLE).
Open Enrollment: Summer 2020
Open Enrollment Period: NOW-5/29/2020
Effective Dates of Coverage: 5/1/2020-8/15/2020 (3.5 months of coverage)
Premium: $824.00 per person; $1648.00 for 2 or more children
This enrollment period is for students and dependents that were NOT enrolled in a predetermined Spring coverage period.
Enrollment in Summer semester credit hours is not required for enrollment in the Summer coverage period to continue the insurance due to a Qualifying Life Event (QLE). The enrollment deadline applies to enrollments due to a previous QLE as well.
All enrollment forms for the Summer coverage period that are received prior to the Open Enrollment Deadline of 5/29/2020 will have coverage backdated to be effective as of 5/1/2020 once the insurance company processes the enrollment.
Enrollment Form Submission:
- Email: firstname.lastname@example.org
Due to the University campus closures, a staff member will be working remotely during the COVID-19 pandemic. Enrollment forms will only be accepted via email to email@example.com until further notice.
Health Insurance Enrollment Form
(Can only be used for Summer 2020 enrollment)
Health Insurance Policy Materials