Cardinal Care Alert!
Attention Freshmen student athletes’ who are planning to enroll in Cardinal Care insurance. Cardinal care is effective 09/01/2017. You will not have medical coverage for the month of August unless you elect to enroll in the “Early Start Cardinal Care coverage.”
Early Start Cardinal Care Coverage - Enrollment Application
August 1, 2017 – August 31, 2017
Freshmen students athletes who are registered for Autumn Quarter 2017-2018 and who have elected Cardinal Care as their primary medical insurance coverage with an effective date of 09/01/2017; BUT who are required by the University to be on campus in August prior to the start of classes may be eligible to purchase Cardinal Care for the month of August 2017. Fees and deadline to enroll are listed on the application. Please fill out the attached Early Start Cardinal care coverage application and return it to Vaden Student Health Ctr.
Freshmen student-athletes enrolled for Summer Quarter classes qualify for Cardinal Care as well; if they do not have another medical coverage option. This coverage is not automatic. The effective period for Cardinal Care Summerquarter is 06/01/2017 – 08/31/2017 and summer quarter fees applies.
If you are a returning student-athlete with Cardinal Care-Healthnet from the previous year 2016-2017, your policy is effective until 8/31/17. You must re-enroll for the academic year 2017-2018.
Please contact Vaden Student Health center at (650)-723-2135.
Early Start Cardinal Care Coverage - Enrollment Application
August 1, 2017 – August 31, 2017
Purpose: Students who are registered for Autumn Quarter 2017-2018and who are required by the University to be on campus in August prior to the start of classes may be eligible to purchase Cardinal Care for the month of August 2017. Please complete this application for coverage and return it to the Health Insurance Office at Vaden Health Center, 866 Campus Drive, Stanford, CA, 94305, no later than Wednesday, July 12, 2017.
NameSUID Number
SSN Number______
Address:
Name of University representative to confirm early start______
Reason for early start
I declare that:
- I will arrive early at Stanford University to conduct University business
- I am requesting enrollment in Cardinal Care effective August 1, 2017 through August 31, 2017
- I understand that a non-refundable fee of $414.00 will post to my university account for this coverage
- I will be a registered student for Autumn Quarter 2017-2018
- I will not waive enrollment in Cardinal Care (Stanford University’s annual student health insurance plan) for the 2017-2018 academic year
Signature:Date:______
Please submit your completed enrollment application to the Health Insurance Office via Help Ticket at helpsu.stanford.edu or fax to 650-725-9970.
Revised 3/17