SHBP Forms, Brochures & ID Cards
View or download Student Health Benefit Plan (SHBP) forms and brochures.
- Spring 2018 Enrollment Form
- Enroll and Change Form 2017-2018
- Student Information Release 2017-2018
- Prescription Reimbursement 2017-2018
- Continuation Options Enroll and Change Form 2017
- Continuation Options Automatic Payment Authorization
- Learning Abroad Waiver 2017-2018
- International Scholar Enroll and Change Form 2017-2018
- International Scholar Payment Form 2017-2018
- International Scholar Waiver Form 2017-2018
- International Scholar Department Authorization 2017-2018
Attention students: Effective August 21, 2017, changes to the Blue Cross and Blue Shield of Minnesota system impact new and existing Student Health Benefit Plan members. All students will have a new member ID number and group number for the 2017-2018 plan year. Because of these changes, even if you previously registered, you will need to register on Blue Cross and Blue Shield’s new member website to see your information. Follow these step-by-step instructions to register and get a virtual or temporary member ID card.
You are able to access your ID card electronically in the BlueCrossMN mobile app. Once you're enrolled on the plan, create an account with BlueCrossMN, then download and begin using the mobile app! The app also gives you access to check claims or find a doctor. The mobile app can be downloaded on the App Store or on Google play.
You will also receive a health plan card and information to your U.S. mailing address on file in MyU. To review or update mailing address, go to the MyU Student Center and click on "My Info." Under Address, update your mailing address.
If you recently updated your address and think your health plan information or card may have been sent to your old address, email your name, student ID number, and the message “I have updated my U.S. mail address with the University and would like a new card sent to me” to firstname.lastname@example.org. The Office of Student Health Benefits must receive confirmation from you that your U.S. mail address is correct before a new card can be issued.
Brochures and Documents
Student Health Benefit Plan
- UnitedHealthcare Global Program Brochure
- UnitedHealthcare Global Info Sheet
- UnitedHealthcare Global ID Card
Student Dental Plans
- Student Dental Plans Enrollment Brochure
- Preventive and Periodontal Plan Summary of Benefits (included in SHBP for primary members)
- Optional Buy-Up Plan Summary of Benefits
- Pediatric Dental Plan Summary of Benefits
- Preventive and Periodontal Dental Plan Full Benefits Summary (included in SHBP for primary members)
- Optional Dental Buy-Up Plan Full Benefits Summary
- Pediatric Dental Plan Full Benefits Summary
Health Plan Benefits Summaries
Choose campus below to view or download your benefit summaries: