Student Health & Wellness!mystudentplan is a benefits plan for students and can provide coverage for prescription drugs, vision care, dental care, mental health counseling, and more. The plan is designed to supplement provincial health insurance and provide additional access to medical services.

 

Online Forms

Are you covered by a comparable plan? Do you wish to cover your dependents? Or have you opted out of the plan and wish to be re-enrolled? Eligible Students may submit their online forms.

Family Add-On Applications

Submit your health and/or dental family add-on application before the deadline.

Fall Application Period

August 1st, 2024 to September 27th, 2024

Make sure to submit your form by September 27th as the online form will be accessible only to eligible students who have lifestyle changes.

Your student account fees only cover you. If you wish the same coverage for your dependents, you can purchase additional coverage using a credit card.

Family Add-On Eligibility

There are 3 circumstances in which students enrolled in the Student Health and Dental Plan may add dependents to their plan: (1) when they are starting the fall term, (2) when they are new students, or (3) when they have a lifestyle change.

How to Add Family

To add dependents, you must be enrolled in the Student Benefits Plan, meet the Family Add-On eligibility criteria, and complete the online form before the applicable term deadline.

Family Add-On Fees:

These are the fees to purchase family coverage, you must pay using a credit card (Visa® or MasterCard®) before the applicable payment deadline.

One dependent Two or more dependents
Health $140.00 Health $140.00
Dental $200.00 Dental $400.00
Health and Dental $340.00 Health and Dental $540.00
  • These are the current family Add-on fees. However, the fees are subject to change without notice.
  • The Family Add-on fees are non-refundable and are not automatically renewed.
  • The Family add-on fees cover your dependents until August 31st. If you wish to keep your family covered, you must submit a new application before the applicable fall deadline.
  • The family Add-On fees are not assessed as part of your term fees. If your application is approved, the Benefits Plan Office emails you a link, the payment deadline, and instructions to pay online using a credit card.
Things to consider:
  • You can only add as a dependent to your Student Benefits Plan your spouse or common-law partner and your children. Parents, grandparents, and siblings do not qualify as dependents.
  • Your dependents would be covered under your Student Benefits Plan, which means they would be entitled to the benefits you have through your plan.
  • Each dependent added uses the same plan card that the student has. The plan card must have the student's information (Full name and student ID).
  • Family Add-On fees are not automatically renewed every fall term. If students wish to keep the dependents covered, they must re-apply every fall.
  • NO EXCEPTIONS will be made if the application or payment is missed. It is the student's responsibility to check their emails regarding the status of the application or deadlines.

Add donotreply@gallivan.ca to your address book. Please do not reply to this email.

Questions? Please contact your Benefit Plan Office: mtroyalplan@mystudentplan.ca

Health and Dental Family Add On Form

Please complete all information on the family add-on form and we will process your application as soon as we can.



Student Information

Sex
Date of Birth
Phone Number
Program Start Date

SAMRU Benefits Plan Office

Email: mtroyalplan@mystudentplan.ca
Phone: 403-440-6267
Address: Room Z001, Wyckham House
4825 Mount Royal Gate SW
4500-50 Street
Calgary, Alberta. T3E 6K6

General Inquiries Line

Monday to Friday from 6:00am to 5:00pm MST

Phone: 1-877-746-5566 Ext. 7249