Student Health Insurance Form

Student Health Insurance Form


2016-2017 Student Health Insurance Plan Student Insurance Form
Please complete this form in its entirety or complete the online waiver/enrollment form located HERE:

I understand that a full-time student at New England Culinary Institute must both enroll in and pay for the NECI Student Health Insurance Plan or document health insurance coverage through another comparable plan. All students will be billed for coverage. Credits will be issued within two weeks from the first day of the initial month of coverage for the full amount billed once proof of private coverage is provided. Therefore (please select one option listed below):

Any student who fails to complete and return either this form or the online waiver/enrollment two weeks prior to their scheduled orientation date, or who provides incomplete information with respect to his or her comparable health plan, shall be enrolled in and billed for the costs of the NECI Student Health Plan for the 2016/2017 academic year.