2019-2020 DSGHP Forms
- To enroll into the DSGHP after September 1st, due to an involuntary loss of other coverage, or during the terms you are enrolled into a study abroad program.
- To cancel the DSGHP coverage for student or dependent(s) on one of the two midyear cancellation dates.
- To enroll qualifying dependents.
DSGHP Medical Claim From
DSGHP Prescription Claim Form
DSGHP Tax Forms & When Coverage Ends Information
- 1099HC (Massachusetts residents only)
- 1095-B (All DSGHP enrollees)
- Extending DSGHP coverage after leaving the college
- HIPAA letter (Proof of coverage terminating, typically needed for enrollment in other health/insurance plans)