FSU | Co-op Health Plan

Co-Op Health Plan (Domestic) Fall 2025

The price of the co-op health plan is $248.85.

This form will enable you to apply for the FSU Health Plan for the academic year by filling in the corresponding application section below.

All forms must be submitted prior to the deadline of September 15, 2025 at 4:00 p.m.

(Coverage is September 1, 2025 through August 31, 2026)

Last Name: *

First Name: *

Middle Initial: *

Student Number: *

Date of birth: *

Gender: * Male Female

Program: *

Phone Number: *

Date: *

FOL email address: *

Opt-in

PLEASE ENROLL ME IN THE FOLLOWING:

(to be eligible, all students must have current OHIP or equivalent coverage)

Fall Deadline: September 15, 2025 at 4:00 p.m.

I wish to apply for: * $248.85 HEALTH BENEFITS (indicate by checkmark) (tax included)

(Pick one of the plan options below): * Balanced Plan Enhanced Dental Plan Enhanced Drug/EHC Plan

I wish to apply for the Fanshawe Student Union Health Plan and agree to be bound by the benefit plan terms and conditions.

Payment: After your form is processed, you will receive an email from ‘The Fanshawe Student Union’ to process your payment securely online through TD Merchant.

Signature: * Type your name in the field above

After presssing submit, it may take approximately 5 seconds before you are redirected to the next screen. Please do NOT press submit a second time.

Important Dates - Fall

Health Plan opt-out:
Opens August 5, 2025 at 9:00 a.m.
Closes September 15, 2025 at 4:00 p.m.
Opt-out
Change your health plan:
Opens August 5, 2025 at 9:00 a.m.
Closes September 15, 2025 at 4:00 p.m.
Change your plan
Family opt-in:
Opens August 5, 2025 at 9:00 a.m.
Closes September 15, 2025 at 4:00 p.m.
Opt-in family members
Part-time post-secondary students opt-in:
Opens August 5, 2025 at 9:00 a.m.
Closes September 15, 2025 at 4:00 p.m.
Opt-in for part-time students

Co-Op Health Plan

Co-Op Health Plan (Domestic) Fall 2025

Important Dates - Fall

Health Plan Documents

Mail-in Claim Forms

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Hours of Operation

Co-Op Health Plan

Co-Op Health Plan (Domestic) Fall 2025

Important Dates - Fall

Health Plan Documents

Mail-in Claim Forms

Quick Links

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Quick Menu

Get in Touch

Hours of Operation