Appeal or Qualifying Event Form

Loss of Health Insurance Coverage

If you have a loss of insurance coverage, please complete the form below and submit to the Student Health Insurance Office. You may email the form to sip@nullwfu.edu or drop off in Reynolda Hall 9A. Please email sip@nullwfu.edu for more information.

If a student is found to have no insurance or insurance that doesn’t meet our criteria (even after applying for waiver), he/she will be enrolled in the Student Blue plan through WFU.

Qualifying Event Form

Insurance Appeal Form

WFU-Appeal-Form

Student Blue and Coronavirus Update

CONTACT SIP

E-MAIL *Recommended*
sip@wfu.edu

PHONE
336.758.4247

To Confirm Policy Benefits
Call Student Blue at 1 (800) 579-8022

MAIL
Student Health Insurance Office
P.O. Box 7312
1834 Wake Forest Road
Winston-Salem, NC 27109

LOCATION
9A Reynolda Hall

STAFF
Ann Madigan
Student Insurance Program Administrator
Finance and Operations, Campus Life