Insurance Forms
Leaves of Absence
If a student is on a university-approved leave of absence the student is eligible to remain enrolled in the NU-SHIP for the remainder of the academic year in which the leave was taken. If the leave extends into the next academic year the student is eligible to remain enrolled for only one more policy year. Please complete the 2024-25 Application to Renew NU-SHIP Coverage and return it back to our office via email. Please note we are unable to process this form until the leave is reflected in the student's record in CAESAR.
Mid-Year Change Forms
- 2024-25 Petition to Add Form (will be posted in the Fall quarter after open enrollment period ends)
- 2024-25 Petition to Cancel Form (will be posted in the Fall quarter after open enrollment period ends)
- 2024-25 Graduation Cancellation Form (will be posted in the Fall quarter after open enrollment period ends)
- 2024-2025 NU-SHIP Withdrawal Cancellation Form
Aetna Forms
- Medical Benefits Claim Form
- Prescription Drug Claim Form
- Medical Exception/Prior Authorization/Precertification Request for Prescription Medications
- Member Complaint and Appeal Form
Plan Comparison
Financial Aid
The financial aid office provides aid to undergraduate students who need to purchase the university plan and who also have significant financial need. The aid provided will depend on your financial need as determined through the financial aid application process. Please complete the Health Insurance Aid Request application. This application is processed by the Office of Financial Aid. Please follow up with them on the status of the application after it is submitted.