FORMS

Enrollment/Opting-In Form

Check out the Important Dates for enrollment periods and policy dates.

How to Enroll:
Enrollment/Opting-In can be completed on the UHCSR website during the open enrollment period.

  • To active your coverage, you must complete the Enrollment Form during the open enrollment period. This must be done before you can:
    • Add dependents
    • Access your digital ID card
    • Use your insurance for medical or pharmacy services
  • If the Enrollment form isn't available online, that means the Enrollment period has closed. 

Why Enrolling Yourself Matters!

  • Even though you will be automatically enrolled if you are eligible, this will only happen after the enrollment period has closed - which takes up to 3 business to process. 
  • There is no additional cost to enroll yourself prior to the enrollment period closing. 

Questions?