NBCCSU - Enrollment Form

Plan Number: 166412
Certificate Number: Student ID
FAQ
Canada Life: 1-800-957-9777
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Student Health and Wellness! mystudentplan provides health, prescriptions, dental, mental health care plus additional benefits for eligible students.

Enroll Applications

Submit your health and/or dental enroll application before the deadline.

Fall Application Period

August 1^st, 2024 to September 13^th, 2024

Make sure to submit your form by September 13^th as the online form will be accessible only to eligible students who have lost their comparable coverage.

Re-Enroll Eligibility

There are 2 circumstances in which students who opted Out of the Student Health and Dental Plan may Re-Enroll: (1) when they are returning students on the anniversary of opting out of the Student Benefits Plan, or (2) when they are within 30 days of losing their alternate Health and Dental coverage.

Eligibility to Re-Enroll

How to Re-Enroll

To apply to Re-Enroll, you must be opted out of the Student Plan, meet the Re-Enroll eligibility criteria, are eligible for the Student Plan, and complete the online form before the applicable term deadline.

Steps to Re-Enroll

Student Health and Dental Fees:

These are the fees to re-enroll in the Student Benefits Plan. If an application is approved, the student receives an email with instructions to pay the assessed fees.

Health	$132.50
Dental	$132.50
Health and Dental	$265.00

Things to consider:

All eligible students are automatically enrolled in the Student Health and Dental Plan and do not need to submit an opt-in form. You will see the Health Plan Fee and the Dental Plan Fee on your student account to confirm you are enrolled.
Students choosing to re-enroll in the Health, the dental or both plans.
Approval of the Student Benefits Plan re-enrollment application will result in the Health Plan Fee and/or the Dental Plan Fee being assessed. You will receive an email informing you how to pay the fees.
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: nbccplan@mystudentplan.ca

The spring-summer enroll deadline is closed.

The spring-summer deadline to apply was May 1o^th, 2024. The online Enroll Form is not available at this time. The online form was open from April 1^st, 2024, until May 10^th, 2024.

NO EXCEPTIONS will be made if the deadline is missed. It is the student's responsibility to pay the plan's mandatory fees, should they miss the applicable opt-out deadline.

If you were eligible for the plan for the first time in the spring-summer or winter term and missed the deadline, the next opportunity to apply will be in the spring-summer or winter 2025 term respectively.

The online form will be open for new and returning students starting in the fall term on August 1^st, 2024. The deadline to apply is September 13^th, 2024.

The online form is only available for students who have lost their comparable coverage.

Eligibility Confirmation

Confirm your eligibility to re-enroll in the Student Benefits Plan by completing the following questions.

Are you a new student considered full-time due to a developmental disability?

Yes

No

Have you ever Opted Out of the Student Health and Dental Plan?

Yes

No

Is the current term the anniversary of opting out of the Student Benefits Plan?

The anniversary refers to the annual occurrence of when you opted out of the Student Benefits Plan. For instance, if you opted out in the winter term, your anniversary of opting out would happen every winter term.

Yes

No

Have you lost your comparable health and dental Coverage?

Yes

No

You meet the eligibility criteria to re-enroll in the plan at this time.

Complete the online form below to submit your application. Completing the questionnaire does not mean that your application is approved, the Student Benefits Plan Office will confirm your eligibility and process your application.

There is a 45-day validation period from the start of the term. During this time, you would have to pay out of pocket for all eligible Health and Dental expenses and keep the receipts. After the enrollment process is complete, you will be able to submit online claims for reimbursement, and your Plan Card will be automatically activated.

Once you submit the re-enroll form, you will receive an automated email confirmation. Please keep this email for your records as it is your only proof of submitting a re-enroll request.

It appears you do not meet the criteria to re-enroll in the plan at this time.

Only students who previously opted out of the Health and Dental Plan may apply to re-enroll.

Eligible Students attending an eligible program as having full-time status will be automatically enrolled in the Student Plan. There is no opt-in option for students attending non-eligible programs or part-time status.

If you have any questions, please initiate a chat by clicking on the right-bottom corner icon or contact the Benefits Plan Office by email at nbccplan@mystudentplan.ca or by phone at 506-858-7873.

It appears you do not meet the criteria to re-enroll in the plan at this time.

Only Students who previously opted out of the Student Plan and have lost their comparable coverage may re-enroll at any time of year within 30 days of the loss of coverage.

The next opportunity to submit your online application would be on the anniversary of opting out of the Student Benefit Plan. You must be eligible for the plan at that time.

If you have any questions, please initiate a chat by clicking on the right-bottom corner icon or contact the Benefits Plan Office by email at nbccplan@mystudentplan.ca or by phone at 506-858-7873.

Health and Dental Re-Enrollment Form

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

Student Information

Student ID Number

Email Address

Confirm Email Address

First Name

Last Name

Sex

F

M

U

Date of Birth

Date Month Field Date Day Field Date Year Field

Phone Number

Phone Area Number Phone Local Number Phone Digits

Program Name

Program Start Date

Date Month Field Date Day Field Date Year Field

Fall Deadline
Submit your online Family Add-On, Opt-Out, or Opt-In applications by September 13^th, 2024

Plan Card Generator
Generate your Plan Card and use it where direct billing to Canada Life is available.

Prescription Search Tool
Find out if your prescription drugs are covered by the student plan.

Plan Claims
Learn more about submitting online or manual claims to Canada Life to get your refund.