2013-14 Waiver Form

Massachusetts Law mandates that all full-time and three-quarter (3/4) time students have health insurance coverage. To ensure compliance with the law, Lasell College students will automatically be enrolled in and billed for the Student Accident and Sickness Insurance Plan, unless proof of comparable medical insurance can be provided and is approved. The insurance charge will be removed from the bill only if proof of other insurance coverage and a waiver are completed by by the first day of classes for the term in which you were billed for insurance.

Comparable coverage means you have access and coverage for visits to local doctors and other healthcare providers, coverage for diagnostic testing and lab services, prescription drug coverage, outpatient mental health coverage, inpatient and outpatient hospital services coverage, as well as emergency services coverage. Your coverage must also remain in effect through August 14, 2014.

IMPORTANT: If you do not submit a waiver of coverage by the first day of classes for the term in which you were billed for insurance, you will be automatically enrolled in the Lasell College Student Health Insurance Plan and responsible for the cost of the plan. Once you are enrolled, the coverage cannot be cancelled.

If you would like to waive out of the Lasell College Student Health Insurance Plan, please continue and complete the following online waiver form. To access the form, enter your nine-digit Lasell Student ID and date of birth below.

If you do not know your Lasell Student ID, you can find it on your Self Service page, under the myProfile tab, on the Account link. If you still have trouble locating it, please contact the Student Accounts Office at (617) 243-2103 or studentaccounts@lasell.edu.