Enrollment Information for Student Dependents
Fall term open enrollment ends 9/30 and Spring term open enrollment ends 2/28.
Before submitting your enrollment form, please take a moment and review the following information:
Insurance Enrollment Form 
Please note: This document is posted in PDF format. To view and print this document, you may need the most recent Adobe Acrobat Reader, a free download is available by clicking here.
Enrollment fees must be term billed.
Credit cards and checks are no longer an option. |
Your enrollment form and required certification can be mailed, faxed or dropped off at:
HUHS 1st Floor - Member Services
75 Mount Auburn Street
Cambridge MA 02138
Our fax number is (617) 496-6125.
If you have any questions on enrollment or benefits please contact Member Services at (617) 495-2008 or email us at mservices@huhs.harvard.edu.
Renewal of coverage is not automatic. A new enrollment form must be submitted to continue coverage.