Student Health and Wellness

Plan Number: 161332
Certificate Number: Student ID
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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.

Family Add-On Applications

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

Winter Application Period

December 1^st, 2024 to January 17^th, 2025

Make sure to submit your form by January 17^th as the online form will be accessible only to eligible students with 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 VISA or Mastercard credit card or a VISA Debit card.

Eligibility Criteria

There are 2 circumstances for adding family members to the Student Health and Dental Plan:

1 Academic Enrollment

Eligible students who wish to extend their benefits to their dependents may apply according to the school enrollment:

Fall Enrollment: All eligible students may apply to add their dependents to the benefit plan before the fall deadline.
Winter Enrollment: Only new eligible students may apply to add their dependents by the winter deadline.
Spring-Summer Enrollment: Only new eligible students may apply to add their dependents by the winter deadline.

If you miss the term deadline, the next opportunity to add family members will be next fall.

2 Lifestyle Change

Students enrolled in the plan who have a lifestyle change such as getting married, meeting the twelve-month co-habitation requirement for common law status, or birth/adoption of a child who wish to extend their plan to their dependents may apply within 30 days of lifestyle change.

To apply, please email proof of Lifestyle Change to the Benefit Plan Office at ridgetownplan@mystudentplan.ca. If you are eligible to add family members, the office will send a link for the application.

Documentation includes a marriage certificate, birth certificate, or adoption documents.

If you miss the lifestyle change deadline, the next opportunity to add family members will be next fall.

Deadline is within 30 days of lifestyle change

Family Add-On Fees for the Fall Term:

One Dependent		Two or More Dependents
Health	$165.00	Health	$165.00
Dental	$165.00	Dental	$330.00
Health & Dental	$330.00	Health & Dental	$495.00

These are the current family Add-on fees. However, the fees are subject to change without notice.
These family fees are not included in your tuition. After the deadline, once your family Add-On is approved, you will be sent a payment link and must pay with a VISA or Mastercard credit card or a VISA Debit card by the applicable payment deadline.
The Family Add-on fees cover from September 1^st to August 31^st for applications approved in Fall. Family Add On requests & fees are not automatically renewed. If you wish to keep the coverage, you must apply again next fall 2024 term.
The fees for Family Add-on are non-refundable.

Important notes:

You can only extend your plan to your spouse or partner and your children. Parents, grandparents, and siblings are not eligible dependents to extend your plan. Please check the eligible dependents.
If you are an international student, please note this is not for emergency coverage. This is extended health and dental coverage for services not covered by an emergency plan. You will be required to provide proof of purchasing emergency coverage for any dependents included on the family add-on form.
The family members would be covered by the same plan the student has.
The benefit year coverage is the same for students and family members. For eligible students starting in the fall semester, coverage begins September 1^st and ends August 31^st. For eligible students starting in the winter semester. Coverage begins January 1^st and ends August 31^st. For eligible students starting in the summer semester. Coverage begins May 1^st and ends August 31^st.
Family Add On requests & fees are not automatically renewed. If students wish to keep the coverage, they must submit a new Family Add-On Application and must pay the additional fees every year by the applicable deadline. The form request deadline and the payment deadline are not the same. The payment deadline is set based on the day the request is approved.
There is a 60-day validation period from the start of the program. 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 Benefits Card will be automatically activated.
Each family member uses the same card that the student has. The card must have the student's information (Student's full name and student ID).
The fees for Family Add-on are non-refundable.
NO EXCEPTIONS will be made if the application or payment deadline is missed. The form request deadline and the payment deadline are not the same. The payment deadline is set based on the day the request is approved. It is the student's responsibility to check their emails.
Once you submit the Family add-on form, you will receive an automated email confirmation. Please keep this email for your records as it is your only proof of submitting a family add-on request.

Steps to Submitting a Family Add-On Application:

1 Student Information

Complete this section below providing true and correct information. Click NEXT.

2 Dependent Information

Scroll down and check Spouse/Child/Children according to the members you wish to add. Provide full name, initials, gender, and date of birth for each member. Click NEXT.

3 Read and Agree to the Terms and Conditions

Click on the checkbox to indicate that you agree to the Terms and Conditions agreement. Click SUBMIT to finish your application.

4 Confirmation Email

Check your email and verify if you have received the confirmation email.
If you do not receive this email, you must resubmit the form.

5 Application Status

You will receive an email with the status of your application.

6 Pay Fees Online

If your application is approved, you will receive a link to pay the applicable fees with your VISA or Mastercard credit card or a VISA Debit card and the deadline to pay them.

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

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

Main Campus Students - Univeristy of Guelph

Please do not submit this form. If you attend the Main Campus and wish to apply, you must complete the online application on the University of Guelph CSA and GSA (Main Campus) Plan website.

The family add-on form is accessible only to eligible students with lifestyle changes.

The fall application period was from August 1^st, 2024 to September 25^th, 2024.

NO EXCEPTIONS are made if the deadline is missed.

Winter 2025: The online applications will open on December 1^st, 2024, and the application deadline is January 17^th, 2025. This deadline is only for new students starting their studies in the winter term. Fall students submitting applications during the winter term will be denied.

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

Student ID Number

Email Address

Confirm Email Address

First Name

Last Name

Sex

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

Winter Deadline
Submit your online Family Add-On, Opt-Out, or Opt-In applications by January 17^th, 2025

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 get your refund.

Benefits Plan Office

Email: ridgetownplan@mystudentplan.ca
Phone: 519-674-1500 Extension 63507
Address:Room 128, 120 Main Street East. D.J. Pestell Student Services & Alumni Centre.
Ridgetown, Ontario N0P 2C0, CA

General Inquiries Line

Monday to Friday
from 8:00am to 7:00pm EST
Phone: 1-877-746-5566

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