Forms » Health Insurance Waiver
Waiver will be granted only for the dates of the mandatory coverage periods as listed below. A new waiver is required at every semester unless insurance is waived for the entire academic year.
All international students holding non-immigrant visas are required to be enrolled in and maintain comprehensive health insurance coverage while enrolled at any UT System institution, including summer semesters, even if student will not be attending classes.
Enrollment in the UTA student health plan is AUTOMATIC when an international student registers for classes each semester, and the cost of the policy will appear on their tuition and fees bill. The insurance premium amount varies per semester. Students enrolling in the UTA student health plan may submit the appropriate enrollment form, to our office during normal business hours: Monday - Friday 8am to 5pm. Questions regarding new and existing claims, coverage and benefits, or requests to add dental coverage or dependents, must be directed to AHP (Academic Health Plan) at http://ahpcare.com/ or (855) 247-2273.
Only students that have comparable coverage will be allowed to waive the UTA student health plan. In order for insurance waivers to be approved, the minimum requirements must be met:
- Mandatory coverage period: Fall semester – Spring & Summer semester : January 1st to August 14th..
- Medical benefits of at least $50,000 per person, per accident or illness;
- A deductible not to exceed $500 per condition;
- Minimum of $7,500 for repatriation of remains;
- Minimum of $10,000 for expenses associated with medical evacuation to the home country;
- Policy plan meets the United States Government's Federal Solvency Guidelines.
Students that are requesting insurance waivers must submit the appropriate waiver form, prior to the semester's census date: Spring : January 29, 2014 to our office normal business hours: Monday - Friday 8am to 4pm or by email to firstname.lastname@example.org. Please allow 3 to 5 business day for processing. Waiver forms must be accompanied by the following documents:
- A copy (front and back) of your medical insurance card and
- A copy of the summary of benefits (in English),
- A letter on company letterhead that:
- Identifies you as the covered individual,
- Provides the start and ends dates of continuing coverage for the entire mandatory coverage period (as indicated on the waiver form),
- Clearly indicates that the coverage meets or exceeds the minimum requirements, including coverage amounts.
If you are not on campus, you can fax. Print the fax cover letter and form below and fax to the number on the fax coversheet. Be sure to include the items listed on the Fax coversheet as noted above.
If you reside outside the DFW metroplex you may refer to the mail-in/mail-out process.