Online SHIP Waiver/Enrollment Form
Only available during open enrollment periods
Use this form to Enroll in Ship or Create a SHIP waiver.
After logging in Select the current term and follow the instructions.
Printable SHIP Waiver/Enrollment Form
This form is for students who are under 18 or otherwise unable to complete the enrollment/waiver process online through Vandal Web. Please fill out all sections of the form completely. Audits of insurance waivers will be conducted and accurate information is necessary for the insurance company to verify coverage and eligibility.
Student Health Insurance Program (SHIP) LATE WAIVER POLICY
Print Proof of Insurance Card--print each semester
After logging in Select the current term and follow the instructions.
If you were enrolled in SHIP for spring semester it includes summer coverage dates so select SPRING 2010.
Special Forms
The forms below can be faxed to 208/885-1002;
mailed to PO Box 444201, Moscow ID 83844-4201;
or dropped off at the SHIP Office, Room 126 in the Student Health Building.
There is a SHIP Office Drop Box at the end of the hall. Please use the University Avenue entrance to the building.
SHIP Qualified Late Enrollee Form--for students who have involuntarily lost employer sponsored health insurance or Medicaid. Documentation showing details of the qualifying event must be attached to the completed form and submitted within 30 days of loss of coverage.
SHIP Enrollment Exception Form--for students who do not meet the standard eligibility provisions for SHIP enrollment. Form must be completed at the beginning of each semester.
Fall semester deadline: September 8.
Spring semester deadline: February 7.
SHIP Dependent Enrollment Form--or SHIP enrolled students adding a dependent spouse or child to their SHIP coverage.
Fall semester deadline: September 8.
Spring semester deadline: February 7.
Dependent Qualified Late Enrollee Deadline: Call 885-2210.
SHIP Dependent Disenrollment Form--for SHIP enrolled students removing a dependent spouse or child from their SHIP coverage.
Fall semester deadline: September 8.
Spring semester deadline: February 7.
SHIP APPEAL FORM
Fax to 885-1002 or drop off
at Student Health Bldg Rm 126
