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.
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 the applicable SPRING TERM when submitting your request.
The forms below can be faxed to: (208) 885-1002;
Mailed to: 875 Perimeter Drive MS 4201, 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 Late Waiver Appeal Request Form
Fax to 885-1002 or drop off
at Student Health Bldg Rm 126
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. If you are adding a Dependent Qualified Late Enrollee please submit a Qualified Late Enrollee Form, a Dependent Enrollment Form and supporting documentation of qualifying event.
SHIP Special Circumstance Enrollment 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.