Opt-Out Applications

Submit your health, dental, or health and dental opt-out application before the deadline.

Fall Application Period

August 1st, 2024 to September 30th, 2024

Make sure to submit your form by September 30th as the online form won't be accessible after that date.

Fall Academic Enrollment
  • All eligible students attending the fall term; and
  • Assessed the Health Insurance Fee and Dental Insurance Fee on their student account; and
  • Must be covered by alternate comparable Health and dental coverage from their parents, spouse, job, government or band; and
  • Must submit their opt out application before the applicable fall deadline.

Eligible students who miss the fall deadline would be able to opt out the following fall term if they are fall-enrolled students. Students will not be able to opt out in the winter term.

Winter Academic Enrollment
  • New eligible winter students or returning students who did not attend fall term; and
  • Assessed the health insurance fee and dental insurance fee on their student account; and
  • Must be covered by alternate comparable Health and dental coverage from their parents, spouse, job, government or band; and
  • Must submit their opt out application before the applicable winter deadline.

New eligible winter students who miss the winter deadline would be able to opt out the following fall term if they are fall-enrolled students.

things-to-considerThings to Consider
  1. A parents' insurance plan could cease to provide coverage when a dependent student turns either 18 or 21, or up to 25 if you are studying full-time at a recognized education institution.
  2. You can combine two benefit plans to maximize your coverage, potentially reaching up to 100% coverage! Find out more Coordination of Benefits.
  3. Students with comparable coverage can choose to opt out of the health and dental plans, or if applicable, you may opt out of one coverage while keeping the other.
  4. Approval of the Student Benefits Plan Opt-Out application will result in the plan fee being refunded according to the applicable school's policy or school association's policy.
  5. 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.

Health and Dental Opt-Out Form

To Opt-Out of the Student Health and Dental Plan, provide us with the following information and we will process your application as soon as we can



Student Information

Date of Birth
Phone Number
Program Start Date

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

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