Voluntary enrollment in USHIP for undergraduate students is managed by USI Insurance Services (USI) for the medical, dental and vision plans. The cost of insurance premiums for voluntary coverage is paid directly to USI. For continuation coverage following graduation, please refer Health Insurance After Graduation.
To enroll in the Medical, Dental and Vision Plans:USI Insurance Services, Inc
(877) 612-7966 (Fax)
10940 White Rock Road, 2nd Floor
Rancho Cordova, CA 95670
Voluntary USHIP Enrollment Forms
Voluntary enrollment for Graduate Students in UC SHIP is managed by USI Insurance Services (on behalf of UC SHIP/UCOP and all carriers). In addition, the cost of insurance premiums for voluntary enrollment is paid directly to USI Insurance Services. Graduate students on voluntary SHIP are not required to utilize the Student Health Center as their primary care provider. However, a referral from SHC is required if you seek medical services from community providers. Contact the SHC Insurance Services department to obtain a referral: email@example.com or 949-824-2388. Exceptions to the referral requirement can be found here: How to use SHIP.
Students enrolled in the programs noted below may purchase voluntary coverage through USI Insurance Services at 800-853-5899. Please use the enrollment form that is applicable to your group.
Voluntary UC SHIP Graduate Student Groups and Corresponding Enrollment Forms:
- 1st Year Medical Students/MSBA(Summer)/Special Programs (Self-Supporting)*/Approved Filing Fee Status/Approved Leave of Absence/Continuation Coverage
- LLM/Approved Filing Fee Status/Approved Leave of Absence/Continuation Coverage
- *Competitive Edge Summer Research Program/MAT (Incoming/Returning/Summer MED/Summer Prime LC (MED)/Other Summer Programs
(For SHIP enrollment of dependents of students who are enrolled in these and other Graduate programs including Summer Session programs, please refer to the "Dependent Enrollment" section below.)
Approved Filing Fee Status
Refers to non-registered students on approved “Filing Fee Status” who are completing work under the auspices of the University of California, but are not attending classes. Filing Fee students are allowed to purchase UC SHIP for a maximum of one semester/quarter. The student must have been covered by the plan in the term immediately preceding the term the student wants to purchase, or, if the student waived enrollment in the prior coverage period, show proof of the plan used to waive. Please use the enrollment form that corresponds to your academic program based upon either the quarter or semester system.
Approved Leave of Absence
Refers to non-registered students on approved “Leave of Absence”. These students are allowed to purchase UC SHIP for a maximum of one semester or two quarters. The student must have been covered by the plan in the term immediately preceding the term the student wants to purchase, or, if the student waived enrollment in the prior coverage period, show proof of the plan used to waive. Please use the enrollment form that corresponds to your academic program based upon either the quarter or semester system.
Coverage of eligible dependents will not be effective prior to that of the insured student or extended beyond that of the insured student. Dependent enrollment or re-enrollment in the plan is not automatic. Eligible dependents must be re-enrolled in each subsequent term in order to continue coverage under the dependent plan. If a student decides to disenroll their dependent(s) during an academic term, then the premiums are non-refundable. Dependents are not eligible to receive services at the Student Health Center and they do not need a referral from SHC to receive medical services from community providers.
Dependents of Graduate Students
All graduate students who are enrolled in UC SHIP have the option to enroll eligible dependents in a voluntary plan. The plan provides medical insurance and the option to add dental and vision benefits. NOTE: If both student parents are covered by UC SHIP, their children may be covered as the dependents of either student, but not both.
Enrollment in the dependent plan is managed by USI Insurance Services (on behalf of UC SHIP/UCOP and all carriers) and the cost of the dependent premiums is payable directly to USI. For dependent plan enrollment questions and plan information, please call Customer Service at USI Insurance Services at 800-853-5899.
Dependent Plan Benefits: Same plan benefits as Graduate Students. Refer to plan materials located in the section above entitled GSHIP Benefits.
Documentation To Show Proof of Dependent Status
Students are required to provide proof of dependent status when enrolling their dependents in the plan. The following documents are acceptable:
- Spouse - marriage certificate
- Same-Sex Domestic Partner - a Declaration of Domestic partnership issued by the State of California, or of same-sex legal union other than marriage formed in another jurisdiction, or a completed declaration of Domestic Partnership Form issued by the University
- Natural Child - a birth certificate showing the student is the parent of the child
- Stepchild - a birth certificate and a marriage certificate showing that one of the parents listed in the birth certificate is married to the student
- Adopted or Foster Child - documentation from the placement agency showing that the student has the legal right to control the child's health care
Dependent Enrollment Forms By Graduate Student Group
(includes Competitive Edge; MAT Incoming; MAT Returning; Summer Returning MED; Summer MED Prime-LC; and Other Summer Programs)