This form allows international students to enroll in the Plan Major supplemental health coverage. The addition of this coverage is done during the modification period. In the winter session, the addition of health coverage is only available to newly enrolled students. If the member loses his or her student status, the coverage will be cancelled without refund.
IMPORTANT: In order to receive coverage, please forward this form, along with your payment to the Plan Major customer service team. Be sure to include all supporting documents necessary to evaluate your file (statement of account and other documents). If the supporting documentation is not received by the end of the amendment period, your request may be denied. Also, be sure to contact Plan Major to find out the cost of the contribution that applies to your situation.
Please note that acceptance of your application for coverage is not automatic, Plan Major evaluates each request individually.