Seneca Polytechnic (International)

Purchase Travel Insurance

Travel Benefit Summary

Claim Form

Purchase Travel Insurance

Travel Benefit Summary

Claim Form

Flex Plan

ARE YOU ENROLLED IN THE HEALTH & DENTAL PLAN?

This is not an application to opt into the benefits. You cannot choose an enhanced plan unless you:

Were charged as a full-time, undergraduate student on your tuition.

Have already completed a part-time or graduate opt-in application and paid the necessary fee of $392.07

UNSURE IF YOU’RE ENROLLED? Look for the LUSU Medical and Dental $392.07 charge on your Myinfo student account statement.

Please select your program

You need to input a valid value for field: School

Please only list the last 9 digits of your student ID number Last 7 digits of your Student Number Last 6 digits of your Student Number Please enter your Student ID number

I confirm I understand this application will not be processed unless I am enrolled before the opt-in deadline (September 30)

You need to input a valid value for field: Agree

You need to input a valid value for field: Student ID number

This Student ID has already made a change of plan for this session.
You will be able to change plan again after this date: {{flexPlanModal.expiryDate}}

PlanDisplay plans overview

First Name

You need to input a valid value for field: First Name

Last Name

You need to input a valid value for field: Last Name

Date of birth - (Year / Month / Day)

Gender

You need to input a valid value for field: Gender

You need to input a valid value for field: Email

Please select this checkbox to indicate that you have read and agreed with our Plan Terms & Conditions.

I understand that I cannot change my plan after confirming as per plan terms.

Please review your data and confirm your decision:

Student ID number	{{flexPlanModal.data.studentNumber}}
Plan Selected	{{flexPlanModal.choosenPlanTitle}}
First Name	{{flexPlanModal.data.firstName}}
Last Name	{{flexPlanModal.data.lastName}}
Date of Birth	{{flexPlanModal.data.dateOfBirth \| date: 'yyyy-MM-dd'}}
Gender	{{flexPlanModal.data.nonBinarySafeGender \| ucfirst}}
Email	{{flexPlanModal.data.email}}

Please wait while your FlexPlan is registered.

Confirmation #{{flexPlanModal.confirmationNumber}}

That is it!

Your SpeakUp flexible Insurance plan details will be emailed to you shortly.

Thanks for Speaking Up!

Print Confirmation

Cannot be undone

Part Time Student Opt-In

Family Opt-In

Student information

Dependents information

Please select your program

You need to input a valid value for field: School

Add dependants is only available to students starting in Winter Semester 2023.

ARE YOU ENROLLED IN THE HEALTH & DENTAL PLAN?

You cannot add dependants unless you have completed a part-time or graduate opt-in application and paid the necessary fee.

Part-time and graduate opt-in is only available to students enrolled in Winter Semester 2023

Available options rates

{{ customizedPartTimeOptinName(pricesOptions.title) }}
{{ customizedPartTimeOptinName(option) }}	${{ price }}

Eligibility Requirements

Terms & Conditions

Please only list the last 9 digits of your student ID number Last 7 digits of your Student Number Last 6 digits of your Student Number Please enter your Student ID number

You need to input a valid value for field: Student ID number

I Agree

This Student ID has already Opt-In for this session.
You will be able to Opt-In again after this date:{{optinModal.expiryDate}}

Sorry this Opt-In session is over.

First Name

You need to input a valid value for field: First Name

Last Name

You need to input a valid value for field: Last Name

Initial (optional)

Date of birth - (Year / Month / Day)

Gender

You need to input a valid value for field: Gender

Street

You need to input a valid value for field: Street

City

You need to input a valid value for field: City

Province

You need to input a valid value for field: Province

Postal Code

You need to input a valid value for field: Postal Code

Phone Number

You need to input a valid value for field: Phone Number

You need to input a valid value for field: Email

Campus

You need to input a valid value for field: Campus

Name of Program

You need to input a valid value for field: Name of Program

Graduate or Part-Time

You need to input a valid value for field: Part-Time or Graduate

Domestic or International

You need to input a valid value for field: Domestic or International

Home Province

You need to input a valid value for field: Home Province

Coverage for

You need to input a valid value for field: Coverage

First Name

You need to input a valid value for field: First Name

Last Name

You need to input a valid value for field: Last Name

Date of birth - (Year / Month / Day)

You cannot add a child older than 25 years old :

You cannot choose a date of birth in the future :

Relationship

Gender

You need to select a valid value for field: Gender

Dependent school start date - (Year / Month / Day)

Start Date cannot be after End Date:

Dependent school end date - (Year / Month / Day)

End Date cannot be before Start Date:

Dependent's accredited school name

You need to input a valid value for field: School Name

Digital signature

You need to input a valid value for field: Signature

The Next button will be enabled once all informations about your dependents is complete.

Choose an option

	Option	Price
	{{ customizedPartTimeOptinName(title) }}	${{ price }}

Please wait while your payment is registered.

The payment failed. Please try again in a few minutes.
If the problem persists, you can contact us via email

Sorry this Opt-In session is over.

Confirmation #{{optinModal.confirmationNumber}}

That is it!

Your Opt-In details will be emailed to you shortly.

Print Confirmation

Thanks for Speaking Up!

Opt-Out

Please select your program

You need to input a valid value for field: School

This online opt-out is available to full-time September intake students only. If you are NOT a September intake student, please be aware that while the online opt-out will accept your request, you are not eligible to opt-out of the Legal Essentials Program and you will not be issued an opt-out refund. If you wish to make alternative arrangements for your opt-out payment other than the direct deposit method, please contact the SRC at KRIZEA01@stclaircollege.ca before the opt-out deadline *I consent that ACL Student Benefits Ltd has my permission to directly send me emails regarding my benefit plan.

Please only list the last 9 digits of your student ID number Last 7 digits of your Student Number Last 6 digits of your Student Number Please enter your Student ID number

You need to input a valid value for field: Student ID number

Reason for opting out:

You need to input a valid value for field: Reason

Please specify an opt-out reason

You need to input a valid value for field: Other Reason

I Agree

This Student ID has already Opt-Out for this session.
You will be able to Opt-Out again after this date: {{optoutModal.expiryDate}}

Campus

Program

You need to input a valid value for field: Program

Year of Study

You need to input a valid value for field: Year of Study

First Name

You need to input a valid value for field: First Name

Last Name

You need to input a valid value for field: Last Name

Date of birth - (Year / Month / Day)

Gender

You need to input a valid value for field: Gender

Address

You need to input a valid value for field: Address

City

You need to input a valid value for field: City

Province

You need to input a valid value for field: Province

Postal Code

You need to input a valid value for field: Postal Code

Phone

You need to input a valid value for field: Phone

You need to input a valid value for field: Email

I am currently not in Canada

I am an international student and I have an OHIP card

Please attach a picture of your OHIP card:

You must include a picture of your OHIP card

You must agree to the terms to continue

I wish to opt out of

Attention: Band Sponsored Students
Please Note: If your band requires you to opt-out of the Student Health Plan, the refund will be refunded/mailed to the band directly.

If your Band has agreed to pay your Full tuition fees please check here

Band Name

You need to input a valid value for field: Band Name

Band Address

You need to input a valid value for field: Band Address

Band City

You need to input a valid value for field: Band City

Band Postal Code

You need to input a valid value for field: Band Postal Code

Band Province

You need to input a valid value for field: Band Province

You must agree to the terms to continue

Proof of required coverage:

Insurer (Name of Insurance Company)

Policy Number (Can be Group # or Contract #)

Primary Subscriber (Name of Insured Parent/Spouse/Self)

The Next button will be enabled once all proofs are complete.

If you wish to make alternative arrangements for your opt-out payment other than the direct deposit method, please contact the Katie Rizea of the SRC at krizea01@stclaircollege.ca before the opt-out deadline.

Refund Method

Account Holder (must be the students name and account)

You need to input a valid value for field: Account Holder

Transit Number (5 digits. Where can I find this number?)

You need to input a valid value for field: Transit Number

Institution (3 digits. Where can I find this number?)

You need to input a valid value for field: Institution

Account Number (Where can I find this number?)

You need to input a valid value for field: Account Number

You are about to opt-out of your benefit coverage.
This means your coverage you selected to opt out of will terminate and you will not be able to make claims. This action cannot be reversed nor can you opt out later for an additional benefit or change the benefit you are opting out of.

Student ID number	{{optoutModal.data.studentNumber}}
Campus	{{optoutModal.data.campus}}
Program	{{optoutModal.data.program}}
Year of Study	{{optoutModal.data.year}}
First Name	{{optoutModal.data.firstName}}
Last Name	{{optoutModal.data.lastName}}
Address	{{optoutModal.data.street}}
City	{{optoutModal.data.city}}
Province	{{optoutModal.data.state}}
Postal Code	{{optoutModal.data.zip}}
Date of Birth	{{optoutModal.data.birth \| date: 'yyyy-MM-dd'}}
Gender	{{optoutModal.data.nonBinarySafeGender \| ucfirst}}
Phone	{{optoutModal.data.phone}}
Email	{{optoutModal.data.email}}
Opt Out of	{{optoutModal.data.target}}
Refund Method	Cheque Direct Deposit Refund will be credited to the student account	Band ({{optoutModal.data.band.name}})

If you wish to proceed with opting out of your benefit coverage, press Confirm. If you want to change details, press Previous.
If not, press Cancel.

Please wait while your Opt-Out is registered.

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Sadly, your application could not be saved

Here are some suggestions:

Try refreshing the page and trying again
Try contacting support through our live chat

Here's what what the errors say:

{{errMsg.field}}: {{errMsg.message}}

Confirmation #{{optoutModal.confirmationNumber}}

That is it!

Your Opt-Out details will be emailed to you shortly. Print Confirmation

↓

	{{plan.title}}
{{category.cat}}	{{item.title}} N/A
	Current plan, no selection required

{{i.title}}

MORE INFO

N/A

Black Out Period Information

Please note that there is a black out period for fall semester 2018 from September 1st to October 12th, 2018. This allows administration time to ensure all students on the plan are registered as full-time students. IGNITE's Flexible Health and Dental plan is retroactive to September 1st, 2018 and all claims submitted during the blackout will be reviewed and processed beginning October 13th, 2018.

There is no blackout period.

Claims Submission Delay Disclaimer

Hello UNB Grads,

Welcome to your first year as a member of the WeSpeakStudent benefits plan.

Our team is excited to have you onboard and we want to ensure you get the most out of your health care.

This year has come with unprecedented changes and setbacks. Unfortunately, one of these setbacks is a delay in getting UNB Grads uploaded and active. This technicality means that you won't be able to submit claims or that your claims may temporarily be rejected until October 1st, 2023. You are still covered from September 1st, 2023, however, please hold onto any receipts or invoices you collect during the month of September so that when the systems are up and running normally, you may submit your claims and receive your reimbursements.

We understand the inconvenience of this situation and appreciate your patience while we navigate this issue.

Thank you!

Purchase Out of Province Travel Insurance

{{additionalTravelInsurance.schoolShortName}} students and employees traveling outside of Ontario on a {{additionalTravelInsurance.schoolShortName}} approved activity of up to 180 days are required to purchase the following Travel Insurance.

You must purchase coverage from the day you leave Ontario to the day you return to Ontario.

To be eligible for this insurance:

You must be covered under a provincial health insurance plan, or other equivalent insurance plan, and;
You must be a registered {{additionalTravelInsurance.schoolShortName}} student or a {{additionalTravelInsurance.schoolShortName}} employee

If you are traveling for a period of more than 180 days, please email global.learning@senecapolytechnic.ca for guidance on how to purchase additional coverage.

Upon purchase:

You will receive an email with the details of your insurance coverage.
- If you would like to read the detailed coverage prior to purchase, please visit the 'Travel Benefit Summary'.
The email will include a confirmation number.
- Seneca students – this confirmation number is required to complete specific forms prior to your departure on your Seneca activity.

Cost: {{(additionalTravelInsurance.pricePerDay / 100) | currency}} per day

Coverage Includes:

Standard Medical Coverage
$5 Million Lifetime Maximum
Trip Cancellation & Trip Interruption
$2K for Lost Baggage
$50K for Accidental Death & Dismemberment
$15K for Repatriation
$30K for Medical Evacuation
Security Evacuation
War risk, terrorism risk, nuclear attacks, biological attacks, or chemical attacks are insured
90-day Pre-existing Condition

For a list of exclusions, please click here

Please select this box to confirm you have read the information and agree to continue.

You need to agree to the terms

You need to input a valid value for field: The item that best describes you

As an international student at Seneca, you may have Travel Insurance coverage through Seneca’s International Student Health Insurance plan with MorCare. International students with MorCare insurance coverage during their Seneca activity do not need to make this additional purchase of coverage UNLESS you are traveling on a Seneca activity for more than 180 days.

Are you travelling outside of Ontario on a Seneca activity that is more than 180 days?
Yes No

Enter your Student ID Number or Employee ID Number:

You need to input a valid value for field: Student Number or Employee Id

First Name

You need to input a valid value for field: First Name

Last Name

You need to input a valid value for field: Last Name

Date of birth - (Year / Month / Day)

Phone Number

You need to input a valid value for field: Phone Number

You need to input a valid value for field: Email

Mailing Address

Street

You need to input a valid value for field: Street

City

You need to input a valid value for field: City

Province

You need to input a valid value for field: Province

Postal Code

You need to input a valid value for field: Postal Code

Destination of Travel

You need to input a valid value for field: Destination of Travel

What date do you depart Ontario? - (Year / Month / Day)

What date do you return to Ontario? - (Year / Month / Day)

The rate is {{additionalTravelInsurance.pricePerDay / 100 | currency}} per day (minimum of {{additionalTravelInsurance.minimumDays}} days)

{{additionalTravelInsurance.getBilledDays()}} days x {{additionalTravelInsurance.pricePerDay / 100 | currency}} = {{additionalTravelInsurance.calculateSubtotal() / 100 | currency}} + {{additionalTravelInsurance.calculateTaxes()/100 | currency}} tax = {{additionalTravelInsurance.calculateTotal()/100 | currency}}

Confirmation #{{additionalTravelInsurance.data.reference}}

That is it!

Thank you for your purchase. Your confirmation number is {{additionalTravelInsurance.data.reference}}. Your travel card and travel brochure have been emailed to you. Please ensure you review the material before your trip.

Print Confirmation

The payment failed. Please try again in a few minutes.
If the problem persists, you can contact us via email

Flex Plan

{{flexPlanModal.choosenPlanTitle}}

That is it!

Thanks for Speaking Up!

Part Time Student Opt-In

Family Opt-In

Student information

Dependents information

{{dependent.header}} {{dependent.firstName}} {{dependent.lastName}}

That is it!

Thanks for Speaking Up!

{{proof.title}}

Oh no - something went wrong

Sadly, your application could not be saved

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That is it!

Black Out Period Information

Claims Submission Delay Disclaimer

Purchase Out of Province Travel Insurance

Coverage Includes:

Mailing Address

That is it!

Exclusions