SARDP - Enrollment Form

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.

Health and Dental Re-Enroll Application

Deadline to re-enroll in the Student Benefits Plan

Spring term - May 14^th, 2024 at 4:00 pm

After the deadline, the online form is only available for 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

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 SA Health Plan and SA Dental Plan fees on your student tuition fee statement 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 on your student tuition fee statement.
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: uofcalgaryplan@mystudentplan.ca

Health and Dental Re-Enroll 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

Spring Deadline
Submit your online Family Add-On, Opt-Out, or Opt-In applications by May 15^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.

SARDP Benefits Plan Office

Email: sahealthplan@rdpolytech.ca
Phone: 403-356-4981
Address: Room 2010A
100 College Blvd
Red Deer, AB T4N 5H5

General Inquiries Line

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

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

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