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Student Insurance Forms & Documents
2025-2026 Policy
2025 Plan Brochure/Certificate (PDF)
2025 Schedule of Benefits (PDF)
2025 Summary Brochure (PDF)
General
Claim Information Form (PDF)
Global Travel Plus Assistance Service Brochure (PDF)
(online)
Payment of Out-of-Network Benefits (PDF)
Pharmacy Claim Form (PDF)
Pharmacy Prescription Drug List (PDF)
Privacy
Authorization from Individual (PDF)Personal Representative Appointment (PDF)
SHC Release of Info to UHCSR (PDF)