Plan Year Specific Forms
2022 - 2023 DSGHP Forms
- 22 - 23 Midyear Enrollment
- To enroll into the DSGHP after September 1st, due to a loss of other coverage, or during the terms you are enrolled into a study abroad program.
- 22 - 23 Midyear Cancellation
- To cancel the DSGHP coverage for a student or dependent(s) onone of the two midyear cancellation dates.
- 22 - 23 Dependent Application
- To enroll qualifying dependents.
- 22 - 23 Waiver Rescindment
- To rescind an approved waiver.